Ramona De Luca, Avellino, Italy, 1984.
She holds a PhD in biomedical engineering and is an acoustic engineer at Esaote. With more than ten years of experience in the field of ultrasound imaging, she moved from academia to industry to unleash her business-oriented mindset. Enthusiasm, sociability, passion and independent thinking are the pillars of her personal and professional life.
Each of us inhabits a complex territory that speaks the secret language of nature. to be explored and safeguarded, it needs increasingly precise and accurate maps. Ultrasound imaging is like a cartographer listening to and drawing the atlas of the human body, showing us the right angles and the paths that can be taken.
Science has more and more of an influence on human life, continually generating an abundance of knowledge that impacts our thoughts, habits, hopes, family and social life, political and economic organizations. It has the power to bring about faster and faster changes, which will prove correct and beneficial only if they make our lives worthy, harmonious, and happy. The balance between knowledge and wisdom is an important factor in order that technology – defined by the British philosopher and mathematician Bertrand Russell as “the armed wing of science” – may offer the means to satisfy different purposes and desires, holding back mankind’s sense of unlimited power, that is the manipulative and destructive of nature.
The use of ultrasound in medicine certainly represents a significant example of how science can provide wonderfully powerful tools that can benefit the daily lives of ordinary people. As well as the fascination and value of such a sophisticated and complex imaging technique, which requires the marriage of physics, physiology, medicine, engineering, and chemistry, there is the idea of equality.
Ultrasound imaging is not intended for a limited oligarchy of privileged individuals, but is meant for the welfare of all. Due to its versatility and adaptability, resulting from the broad spectrum of both technologies and clinical applications, it offers advanced, customized solutions while also playing an important role in healthcare in remote and rural areas.
Scientific discoveries can arise as a result of a disinterested love for knowledge, to generate understanding, culture, and beauty, or for their concrete use. In the latter case, a substantial role has historically been played by research and development into technologies expressly intended for military purposes. Driven by his curiosity in the late 18th century, the Italian biologist Lazzaro Spallanzani realized that bats do not use their eyes but their ears to move around the environment and detect obstacles and prey. But it took until the 20th century for science to prove that bats use the ultrasound they emit to orient themselves and hunt. In the years that followed, engineers, physicists, and doctors began to hypothesize about the use of ultrasound to produce images of the abdomen, brain, and heart, exploiting the operating principle of SONAR (an acronym for SOund NAvigation and Ranging), originally developed during the First World War to detect the presence and position of submarines. However, it was not until the 1960s that we had the first ultrasound machines for clinical use. Since then, with the impetus of technological innovation, we have witnessed a progressive search for the details of the composition of the human body using ultrasound, reproduced in a language that is globally recognized and understood.
The goal of science is to generate a means of obtaining knowledge and producing change that is valid for all places, all peoples, all cultures. The challenge lies in the observation of complex phenomena and their description and representation/ reproduction of this with simple, balanced, and comprehensible tools, at the service of both the individual and the social organism. The German physicist Albert Einstein was one of the pioneers of the concept of the aesthetic principle of modern science: a theory must not only explain data, it must have its own mathematical beauty. With a bold analogy to both the heuristic and evaluative function of mathematical beauty in the theory of general relativity, it can be argued that the significance of observing the interior of the human body by means of ultrasound can be fully understood if the image of the body it generates is not only truthful, but also harmonious, complete, and ordered. This image must be combined with knowledge of the anatomy, with its axes and planes of reference, and of physiology in order to be usable by the physician, or rather by all physicians.
Science is not exact, in that as knowledge progresses it is subject to change at an increasingly rapid rate. The English physicist, mathematician, and astronomer Isaac Newton gradually refined his theory of universal gravitation over twenty-one years before publishing it. No contemporary scientist would dare to do this, because in our era the scientific picture could change completely in the space of 21 years.
Medical ultrasound imaging is governed by the driving force of innovation; we are seeing a continuous and rapid expansion of technologies, resulting in new perspectives and tools for the benefit of the customer. In this context, the definition of customer is twofold: on the one hand, the user (in general, the physician) and, on the other hand, the patient. The goal is to increase the benefits and performance of ultrasound for both the physician and the patient by investing in the development of new technologies that provide additional or complementary diagnostic information to conventional techniques. To cite a significant example, in 2002 Esaote introduced Fusion Imaging, a technology to fuse real-time ultrasound images with CT/MR/PET-CT images. In addition to the technological development aimed at an increasingly accurate and reliable diagnosis, the scientific community and both the clinical and industrial worlds are showing a growing interest in optimizing the usability and ergonomics of the workstation (in particular of the ultrasound scanner and the probe) in order to reduce the incidence of musculoskeletal disorders among ultrasound professionals.
Thinking outside the box, investigating radical hypotheses, and introducing new ways of thinking are the key means of continuing to generate knowledge, along with curiosity and passion. Typically in the medical field, creativity and innovation are initially perceived with skepticism and it can take several years before an invention is recognized and accepted. This is the experience and testimony of Iranian-American biologist Mina Bissell, whose work has changed the way we think about cancer. Overcoming considerable initial doubts over her unorthodox ideas regarding cancer growth and behavior, her model based on the reciprocal and dynamic interaction of form and function at the level of tissue organization, has since contributed to numerous advances in the understanding of cancer mechanisms and the development of new therapeutic approaches against cancer. Mina Bissell is a great example of passion, ingenuity, tenacity, and courage, tied up with the love of knowledge that drives the advancement of science. This is complemented by a practical sense that fosters the success of innovations in medicine and accelerates translational research.
In terms of applied research and technology development by companies, intellectual property rights come into play, as companies are profit-oriented as well as knowledge-driven. The balance between economic interests and research lies in the responsibility for ensuring good health and well-being for everyone. In this scenario, cooperation, sharing, and involvement are essential for working together by pooling results and skills, and for acquiring new knowledge by following unexplored perspectives.
Crucial to increasing the communication and sharing of science has been digitization, which has also helped to improve understanding of scientific and technical knowledge by non-experts. All of this makes for a democratic scientific society.
The progress of science in general and the history of ultrasound in medicine in particular, teach us that, driven by passion, curiosity, wisdom, and cooperation, we can discover new horizons and introduce new ways of thinking and acting in the clinic, for the benefit of all humanity.