A Review on Biological Effects of Ultrasounds: Key Messages for Clinicians
Carla Maria Irene Quarato,
Donato Lacedonia,
Michela Salvemini,
Giulia Tuccari,
Grazia Mastrodonato,
Rosanna Villani,
Lucia Angela Fiore,
Giulia Scioscia,
Antonio Mirijello,
Annarita Saponara,
Marco Sperandeo
Affiliations
Carla Maria Irene Quarato
Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Donato Lacedonia
Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Michela Salvemini
Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Giulia Tuccari
Department of Medical and Surgical Sciences, Institute of Geriatric, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Grazia Mastrodonato
Department of Basic Medical Science, Neuroscience and Sensory Organs, Institute of Sports Medicine, University “Aldo Moro” of Bari, 70122 Bari, Italy
Rosanna Villani
Department of Medical and Surgical Sciences, Institute of Internal Medicine, Liver Unit, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Lucia Angela Fiore
Department of Medical and Surgical Sciences, Institute of Geriatric, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Giulia Scioscia
Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
Antonio Mirijello
Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Annarita Saponara
Unità Sanitaria Locale (ASL) di Potenza, 85100 Potenza, Italy
Marco Sperandeo
Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Ultrasound (US) is acoustic energy that interacts with human tissues, thus, producing bioeffects that may be hazardous, especially in sensitive organs (i.e., brain, eye, heart, lung, and digestive tract) and embryos/fetuses. Two basic mechanisms of US interaction with biological systems have been identified: thermal and non-thermal. As a result, thermal and mechanical indexes have been developed to provide a means of assessing the potential for biological effects from exposure to diagnostic US. The main aims of this paper were to describe the models and assumptions used to estimate the “safety” of acoustic outputs and indices and to summarize the current state of knowledge about US-induced effects on living systems deriving from in vitro models and in vivo experiments on animals. This review work has made it possible to highlight the limits associated with the use of the estimated safety values of thermal and mechanical indices relating above all to the use of new US technologies, such as contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) shear wave elastography (SWE). US for diagnostic and research purposes has been officially declared safe, and no harmful biological effects in humans have yet been demonstrated with new imaging modalities; however, physicians should be adequately informed on the potential risks of biological effects. US exposure, according to the ALARA (As Low As Reasonably Achievable) principle, should be as low as reasonably possible.
