Role of biplane echocardiography in a large-volume clinical practice: Revamping strategies for echocardiography in a limited time

Objectives: We determined the feasibility, learning curve, time efficacy, and the quality of imaging during biplane echocardiography performed in clinical practice with a view to reduce a sonographer's time for image acquisition. Background. Multidimensional echocardiographic imaging has improved the assessment of cardiac geometry and function in clinical settings. However, concerns regarding case of performance and effects on overall clinical work flow remain inadequately addressed. Methods: The study included 100 consecutive unselected patients referred to our echocardiography laboratory. They were randomized to conventional or biplane echocardiography performed by a sonographer without previous knowledge of biplane imaging. Image acquisition time and variables influencing the learning curve and overall image quality were analyzed. Results. Mean time required for biplane and monoplane imaging was not different in the first 24 cases. In the remaining cases, mean image acquisition time was reduced significantly in 58 cases (76.3%): biplane, 5.6 minutes (SD 1.3); and monoplane, 6.15 minutes (SD 1.6) (P =.0003). For both techniques, scanning time was not affected by referral pattern, body habitus, or underlying cardiac lesion. Overall., biplane scanning resulted in reduction in echocardiographic imaging time of 9.1%, maintaining an acceptable image quality in 87% of patients. In the last 20 cases, new software design and superior instrumentation technique improved the mean time gain to 15%. Conclusion: In a high-volume echocardiography laboratory, biplane imaging effectively reduces sonographer time for imaging and improves throughput by increasing the number of comprehensive ultrasound studies that can be performed in a limited time.