Above is my picture at Windsor general hospital -in Windsor Ontario working with the top of the line ultrasound machine at that time called the contact scanner- 1984.LOL

Steve Ramsey beside the contact scanner and the CW Doppler machine-1984

The History of Ultrasound

The history and evolution of diagnostic ultrasonography have been founded on the combined efforts of physicists, engineers, computer scientists, doctors, sonographers, physiologists, university researchers, as well as large commercial companies and individual entrepreneurs.

Early Evolution of High-Frequency Sound (1794 – 1893)

1794 – Lazzaro Spallanzani, an Italian physiologist, and biologist discover that bats navigate in the dark through the reflection of high-frequency sounds (echolocation). Spallanzani’s discovery becomes the basis of ultrasound physics.

Lazzaro Spallanzani

1801 – Thomas Young, an English physicist, discovers that light waves from multiple sources can combine to become stronger or cancel each other out depending on the shift of the light.

1816 – Rene T. H. Laennec, a French physician, invents the stethoscope after rolling a ream of paper in order to amplify the sound of a patient’s heart.

1826 – Jean-Daniel Colladon, a Swiss physicist, uses a Church bell underwater to determine the speed of sound in Lake Geneva. Colladon discovers that sound travels faster through water than air.

1842 – Christian Andreas Doppler, an Austrian mathematician, and physicist, suggests that the frequency of a sound wave depends on the speed of the source. This discovery would later be known as the ‘Doppler Effect‘.

1876 – Francis Galton, an English polymath, invents the Galton Whistle which produces a high-frequency sound (ultrasound) inaudible to human ears.

Steve Ramsey with the Aucoson ultrasound machine used for carotids and other exams.back in 1987

Pierre Curie

1877 – John William Strutt, an English physicist, first describes sound waves as mathematical equations in his textbook The Theory of Sound.

1880 – Pierre Curie and brother Jacques Curie, both of whom are French physicists, demonstrate the first piezoelectric effect, the ability of certain materials to generate an electric charge in response to mechanical stress, using crystals of tourmaline, quartz, topaz, cane sugar, and Rochelle salt.

1881 – Gabriel Lippmann, physicist, and inventor, mathematically deduce from thermodynamic principles the converse piezoelectric effect.

1900’s to 1930’s

1914 – Reginald Aubrey Fessenden, a Canadian inventor, designs the first working sonar system in the United States. The sonar system emits a low-frequency sound and listens for echoes. Reginald Fessenden’s sonar system helps detect icebergs.

Reginald Aubrey Fessenden.

1917 – Paul Langevin, a French physicist, and Constantin Chilowsky use ultrasound to detect the presence of submarines and is the first technological application of ultrasound. (Hydrophone)

1924 – Edward Victor Appleton, an English physicist, uses radio echoes to determine the height of the ionosphere (a region of the upper atmosphere).

1928 – Sergei Sokolov, a Soviet physicist, proposes using ultrasonic waves to detect flaws in metals. Sokolov is later referred to as the father of ultrasonic testing.

1935 – Robert Watson-Watt, an English physicist, invents the first practical RADAR system in order to detect aircraft.

1940’s

1942 – Karl Theodore Dussik, an Austrian neurologist, and psychiatrist at the University of Vienna, uses ultrasonic beams transmitting through the head to diagnose brain tumors (Hyperphonography). Dussik becomes the pioneer of diagnostic ultrasound.

Karl Theodore Dussik

1947 – Dussik develops an apparatus to make images of the brain and ventricles using heat sensitive paper to record the echoes of the ultrasonic transmissions. The images are called ‘ventriculograms‘.

1948 – The First Congress of Ultrasound in Medicine meets in Erlangen, Germany. Karl Dussik and Wolf-Dieter Keidel are the only two individuals to present on the use of ultrasound in medical diagnostics. The other individuals present discuss ultrasound in therapeutics.

1949 – George Döring Ludwig, an American professor of medicine, is credited with developing the first application of ultrasound for diagnosing gallstones. Ludwig uses reflective pulse-echo ultrasound to detect the presence of gallstones in animal tissues. George Ludwig’s work had started several years prior, however, it remained classified by the U.S. Navy until October of 1949. Ludwig’s report is the first of its kind in the United States.

1949 – John Julian Wild, an English born physician, becomes interested in treating bowel distention and determines he needs to measure changes in the thickness of the bowel wall in order to best treat the condition. Wild considers pulse-echo ultrasound as a possible solution.

1949 – Douglass Howry, an American radiologist, develops a pulse-echo ultrasonic scanner using spare parts from radio stores and surplus radar equipment from the Air Force. A year later Howry uses a 35mm camera to record the pictures of the ultrasound.

1950’s

1951 – Douglass Howry with the help of Joseph Holmes, an American nephrologist, develops a B-mode linear compound ultrasound scanner to include superior transducers, amplifiers, and display imaging. Howry and his team introduce compound scanning in order to eliminate ‘false’ echoes. Compound scanning allowed Howry to differentiate between structures and tissues which ultimately produced better imaging and were the referred to as ‘sonagrams‘.

Douglass Howry

1952 – The American Institute of Ultrasound in Medicine (AIUM) is founded.

1953 – Inge Edler, a Swedish physician, and engineer Carl Hellmuth Hertzperform the first successful in an effort to diagnose mitral stenosis.

1953 – John J. Wild and John M. Reid, an electrical engineer, produce real-time ultrasound images at 15 M/c of a cancerous growth on a human breast. Wild and Reid coin the method an ‘‘.

1954 – Inge Edler and Carl Hertz describe the M-mode display using a modified metal-flaw detector. The M-mode display is then able to record cardiac valvular motion.

1955 – Shigeo Satomura, a Japanese physicist, and his team implement Doppler shift techniques in monitoring the pulsations of a heart and peripheral blood vessels. It becomes the first medical application of the Doppler Effect.

1957 – The Pan Scanner is introduced. The transducer rotates in a semicircular motion around the patient and does not require full immersion in order to identify a controlled sound beam. Previous technology required the patients to be completely submerged in water.

1957 – Thomas Graham Brown, a Scottish engineer, along with Ian Donald, a Scottish physician, invent the first Compound B-Mode contact scanner. The transducer operates at 2.5 MHz.

1958 – Ian Donald publishes an article in The Lancet, a medical journal, titled Investigation of Abdominal Masses by Pulsed Ultrasound. Ian Donald becomes the father of OB-GYN ultrasound. Donald uses ultrasound to detect abdominal tumors and cysts and later is able to detect a twin pregnancy.

1960’s

1962 – Joseph Holmes, together with engineers William Wright and Ralph Meyerdirk develop a new compound contact scanner using wire mechanisms and electronic position transducing potentiometers. The transducer is the first of its kind to be positioned by hand.

Joseph Holmes

1963 – The first hand-held compound contact B-mode scanner is commercially launched in the United States. This was the beginning of the most popular design of ultrasound scanners.

1965 – The “First International Conference on Diagnostic Ultrasound” is held in Pittsburgh, Pennsylvania and is attended by most of the ultrasound pioneers.

1965 – Walter Krause and Richard Soldner invent a real-time imaging scanner. Siemens begins manufacturing the real-time scanner under the name Vidoson.

1966 – Don Baker, John Reid, and Dennis Watkins design pulse Doppler technology that was able to identify blood flow through the heart.

1967 – Gene Strandness, an American physician, develops technologies to use Doppler imaging in order to detect peripheral vascular disease.

1969 – The “First World Congress on Ultrasonic Diagnostics in Medicine” was held in Vienna.

1970’s

1970 – The American Society of Ultrasound Technical Specialists (ASUTS) is formed. The ASUTS would later become the Society of Diagnostic Medical Sonographers and then finally the Society of Diagnostic Medical Sonography.

1972 – Paul Hugenholtz, a renowned cardiologist, in collaboration with Organon Teknika, a Dutch company, produce the ‘Multiscan System‘, the first commercial linear array scanner in the world.

1973 – George Kossoff, along with William Garrett, David Carpenter, and George Radovanovitch develop a new scan converter with gray-scale technologies. Gray-scale imaging allowed for the identification of different textures.

1973 – Martin H. Wilcox, an American electrical engineer, designs the first commercial abdominal linear-array real-time scanner with good resolution.

1973 – James Griffith and Walter Henry produce an oscillating real-time scanning device that is capable of producing high resolution real-time sectoral images. This 2D scanning device is credited as being one of the most significant developments in sonography.

1974 – Frank Barber, Don Baker, and John Reid develop the first duplex pulsed-Doppler scanner. The duplex scanner enables 2D gray-scale imaging in order to guide the ultrasound beam.

1974 – The American Registry of Diagnostic Medical Sonographers is founded by the Society of Diagnostic Medical Sonographers (SDMS).

1975 – Marco Brandestini and his team at the University of Washington obtain blood-flow images using a 128-point multi-gated pulsed Doppler system. The ultrasound images were encoded in color and superimposed on 2D anatomical images.

1976 – Albert Waxman and his team develop one of the first digital scan converters with memory. Digital scan converters begin to replace analog systems.

1980’s

1981 – The first sonography program is accredited by the Joint Review Committee for Education in Diagnostic Medical Sonography (JRC-DMS).

1983 – Quantum Medical Systems® introduces the concept of real-time color Doppler imaging at the American Institute of Ultrasound in Medicine (AIUM) meeting. The first color images were displayed a year later.

1985 – Chihiro Kasai, Koroku Namekawa, and Ryozo Omoto of Tokyo, Japan realized that real-time color flow imaging could be a practical possibility.

Olaf von Ramm

1987 – The Center for Emerging Cardiovascular Technologies at Duke University headed by Olaf von Ramm begins to develop a real-time 3D volumetric scanner for imaging the cardiac structures.

1989 – The Combison 330 becomes the first commercial 3D scanner on the market.

1989 – Daniel Lichtenstein, a French professor, pioneers general ultrasound in intensive care. Lichtenstein calls ultrasound ‘the real stethoscope‘.

1990’s

1994 – Olaf von Ramm and Stephen William Smith of Duke University produce an improved scanner that provides high resolution down to 20 centimeters. The duo and their team develop a state-of-the-art “Medical Ultrasound imaging” integrated circuits (MUsIC) which are capable of processing signals from multiple real-time phased-array images.

1996 – Thomas Nelson and his team publish independent studies on 4D (motion 3D) fetal echocardiography, using sonographic cardiac gating methods in order to remove motion artifacts, which are commonly present with static 3D methods.

The innovation which had soon completely changed the practice of ultrasound scanning was the advent of the Real-time scanners. The first real-time scanner, better known as fast B-scanners at that time, was developed by Walter Krause and Richard soldier (with J Paetzold and Otto Kresse) and manufactured as the Vidoson by Siemens Medical Systems of Germany in 1965. D Hofmann, H Holländerand P Weiser published it’s first used in Obstetrics and Gynecology in 1966 in the German language. Hofmann and Holländer’s paper in 1968 on ” IDHF-ultrasound” also in German, is probably the first paper in the medical literature describing formally the diagnosis of a fetal malformation using ultrasound.

Linear array and annular array technology had also been heavily investigated by the Japanese since the early 1970’s who had been moving ahead very successfully with innovative electronic engineering in many domestic, commercial and professional sectors.

The Kossoff group in Australia had also made significant progress in the annular phased array transducer designs as early as 1973 and the technology was incorporated into their water-bath scanner, the UI Octoson. In England, EMI produced the Emisonic 4500, a phased-array sector scanner which was nevertheless expensive, electronically noisy and had an inferior resolution in the near fields. Early phased-arrays in the late 70s were all used in cardiac applications. Important manufacturers included Varian and Irex. In the first half of the 1980s, image quality in phased-arrays had continued to improve and some outstanding designs had come from Irex and later on Elscint (Dynex) and Hewlett Packard®. Despite the small probe size, phased-array sector scanners had never been popular with Obstetrical and Gynecological examinations.

Ultrasound scanners came into different categories according to their performance and price. From the early 1980s, scanners have started to move into clinics and private offices and there is a trend to decentralize ultrasound services all over the world. Acceptance and demand from the lay public have also increased exponentially coupled with increased utilization by various medical specialties and sub-specialties. Standards and quality of scans became an emerging problem not seen in other areas of medical imaging, where Radiologists received the relevant training and underwent appropriate examinations before running the service. Obstetricians were simply using the scanner probe as a torch to “look inside” the uterus. Standards varied and misdiagnosis was not uncommon. Obstetricians and Gynecologists took on the fact that they are the more suitable persons to do the scans as compared to their radiological colleagues. Special training centers and accreditation boards were gradually set up by the health authorities in the United States, Australia, Europe and other countries.

Steve Ramsey, Ph.D. – Calgary – Alberta