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So to our fifth learning objective,

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select appropriate imaging modalities for intraprocedural visualization.

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So when we think about imaging guidance, we have an amazing assortment of tools.

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We have ultrasound, we have CT, and we have fluoroscopy.

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So let's talk about ultrasound.

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So every time you open your toolbox, in this case, imaging guidance,

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when you look at a tool, you want to know the pros, the cons,

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the benefits, and maybe the pitfalls, you know, associated with that particular modality,

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so that you can wield it to your patient's benefit.

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So when it comes to advantages of ultrasound, it's real-time.

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You can literally scan this patient, you know,

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and identify your needle as it moves into the abscess.

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You can watch your catheter as being advanced over the wire into the abscess.

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You can monitor yourself as you traverse

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tissue planes along the path of the abscess.

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One of the things that I love is the fact that you can go off access, right?

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You know, instead of going in plane, in the axial plane, as you would with CT,

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in the absence of being able to angulate the actual tube, what you can do here is

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you can go off access. You know, wherever you direct your wand,

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your sonographic probe,

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that's where your needle is obviously going to be aligned and you can

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essentially guide yourself safely into that abscess,

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pretty expeditiously.

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One of the beautiful things, which is, you know, what I appreciate when it comes

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to the pediatric population, is there's no ionizing radiation.

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And so, if you're asked to drain an abscess in a pediatric population or even

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a pregnant mother, this is just awesome because of this absence

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of ionizing radiation associated with this modality.

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And of course, sick patient on the floor, if you're sort of the kind

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of interventional radiologist that takes your show on the road,

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being able to go up to the floor with a portable ultrasound is amazing.

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It allows you to go up to the room

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in a patient that maybe a little be, a little sick to bring down.

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Maybe you could do it,

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but you may think that, you know, this may be for the patient's benefit to go to the room.

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I feel like it's not going to put me in an unsafe position to care for this patient,

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I'm willing to do that.

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So being able to have that portability, that's a nice option.

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Okay? So when it comes to disadvantages, one of the things I like to think about is

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the fact that, you know, when you have air just hanging out in the abdomen and bowel,

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that may not actually be too helpful because it may confound your ability

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to distinguish sort of other air-filled structures,

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a la abscesses from natural anatomic air

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filled and fluid field structure cyst, a la bowel.

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So, maybe a little hard to distinguish. So that's the first thing.

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The other thing is, you know, the fact that there's

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individuals that are on this planet that are all shapes and sizes, you know,

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the issue with ultrasound is it often has

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difficulty penetrating, difficulty sort of accessing individuals

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that may actually have a little bit more girth.

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And that is something that we want to be respectful of and mindful of.