How the AIUM Helps Improve Medical Ultrasound Safety

Medical ultrasound is one of the most widely used imaging technologies in healthcare because it is noninvasive, does not use ionizing radiation, and can provide real-time diagnostic information, and has even moved into therapeutics. Ensuring that ultrasound is used safely and effectively is a core part of the mission of the American Institute of Ultrasound in Medicine (AIUM), a multidisciplinary organization dedicated to advancing the safe and effective use of ultrasound through education, research, guideline development, and accreditation. In recognition of Medical Ultrasound Awareness Month, we wanted to share all of the ways that we help make the use of ultrasound safer in medical applications. 

Developing Evidence-Based Safety Guidance 

One of the AIUM's most important contributions to ultrasound safety is the development of comprehensive guidance documents and official statements that help clinicians understand and manage potential risks associated with ultrasound exposure. The organization regularly reviews scientific evidence on ultrasound bioeffects and updates its recommendations as new research emerges. 

A cornerstone of these efforts is the AIUM's Medical Ultrasound Safety (MUS) manual. The document explains potential ultrasound-induced bioeffects, including thermal and mechanical effects, discusses the balance of risks and benefits associated with diagnostic imaging, and provides guidance on using ultrasound equipment responsibly. The resource also supports implementation of the principle of keeping patient exposure "As Low As Reasonably Achievable" (ALARA) while still obtaining the diagnostic information needed for patient care. 

Supporting the ALARA Principle 

The ALARA principle is central to modern ultrasound safety. The AIUM promotes the idea that ultrasound users should minimize patient exposure while maintaining diagnostic quality. This means operators should use the lowest output settings and shortest scan times necessary to answer the clinical question. 

To support this approach, the AIUM provides education on the interpretation of safety indicators displayed on ultrasound systems, including the Thermal Index (TI) and Mechanical Index (MI). These indicators help clinicians assess the likelihood of thermal or mechanical bioeffects during an examination and make informed decisions about scanning parameters.  

Evaluating Scientific Research on Bioeffects 

The AIUM maintains a dedicated Bioeffects Committee, whose responsibility is to evaluate research related to the biological effects of ultrasound and provide information to healthcare professionals regarding the safe use of ultrasound. The committee includes input from experts and representatives from federal agencies and external organizations, helping ensure that safety recommendations reflect the current scientific consensus. https://www.aium.org/about-us/committees 

The organization's official statements on biological effects summarize decades of laboratory and clinical research. These documents explain how ultrasound interacts with tissues, identify factors that can influence risk, and discuss considerations for particularly sensitive populations, including fetuses and newborns. They also describe the scientific basis for the Mechanical Index and Thermal Index used in clinical practice. 

Establishing Standards for Safe Clinical Practice 

Beyond acoustic safety, the AIUM develops standards and guidelines that help healthcare facilities provide high-quality ultrasound services. These resources address examination performance, clinical protocols, quality assurance (QA) processes, and equipment management.  

The AIUM's quality assurance guidance emphasizes that ultrasound equipment and clinical practices should be consistently safe, accurate, and reliable. Recommended QA programs help facilities identify equipment problems that could affect image quality while incorporating routine safety and cleanliness checks. The practice must also show ongoing monitoring of all ultrasound personnel, including physicians, non-physicians, and sonographers, through regular, retrospective, performance reviews. Written documentation of these reviews should be maintained to verify ongoing quality and compliance with established standards.  

Promoting Infection Prevention 

Patient safety extends beyond ultrasound exposure itself. The AIUM publishes detailed recommendations for cleaning and preparing ultrasound transducers and equipment between patients, as well as guidance for the safe handling and use of ultrasound coupling gel. These recommendations address disinfection practices, use of protective barriers, infection prevention, equipment inspection, and safe gel management.  

By providing clear protocols for routine cleaning and disinfection, the AIUM helps reduce the risk of cross-contamination and healthcare-associated infections during ultrasound examinations.  

Educating Ultrasound Professionals 

Education is another key element of the AIUM's safety strategy. Through practice parameters, training materials, official statements, safety-focused resources, and ongoing educational opportunities in person and online, the organization helps physicians, sonographers, nurses, and other healthcare professionals stay informed about best practices. The AIUM specifically recommends that all healthcare professionals involved in ultrasound use follow the guidance contained in its Medical Ultrasound Safety resource.  

A Commitment to Continuous Improvement 

Ultrasound technology continues to evolve, and the AIUM regularly reviews and updates its safety documents to reflect new evidence, technological advances, and changing clinical practices. Through scientific review, educational initiatives, quality assurance guidance, infection control recommendations, and promotion of the ALARA principle, the AIUM plays a leading role in helping ensure that medical ultrasound remains both safe and effective for patients.  

As a demonstration of meeting or exceeding nationally recognized standards in the performance and interpretation of diagnostic ultrasound examinations, practices can earn AIUM Accreditation. The accreditation process encourages providers of diagnostic ultrasound services to assess their strengths and weaknesses and initiate changes to improve their practices.