Tips and Insights on Choosing the Right Ultrasound Paper

With so many options available on the market, choosing the right ultrasound paper can be difficult. However, selecting the proper thermal paper for your practice is essential to ensure high-quality imaging and accurate diagnosis.

With the right thermal paper, you can achieve better contrast, resolution, and detail in your ultrasound images, leading to more precise screenings and better patient care. In this article, we will guide and provide you with all the information you need to know how to choose the right media paper for your practice.

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As you already know, ultrasound has quickly become an essential tool in modern medicine, revolutionizing the way doctors diagnose and treat patients. To fully understand and make the right choice in ultrasound thermal paper, we'll first go over some of the history of this increasingly popular imaging modality.

A Short Story About Ultrasound in Medicine

According to the History of Ultrasound in Obstetrics and Gynecology by Joseph Woo, initially, ultrasound was used in therapy rather than diagnosis due to its heating and disruptive effects on animal tissues. However, in the 1940s, there were enthusiastic claims made about the effectiveness of ultrasound as a cure-all remedy for various conditions, even though there was little scientific evidence to support such claims.

It was around this time that ultrasound was first used experimentally as a possible diagnostic tool. H. Gohr and Th. Wedekind at the Medical University of Koln in Germany presented the possibility of ultrasound diagnosis in a paper published in 1940, but they were unable to produce convincing results.

Karl Theo Dussik, a neurologist and psychiatrist at the University of Vienna, Austria, is generally regarded as the first physician to employ ultrasound in medical diagnosis. In 1947, Dussik and his physicist brother Friederich attempted to locate brain tumors and cerebral ventricles using ultrasound technology. They developed a through-transmission technique with two transducers placed on either side of the head, producing echo images of the ventricles of the brain.

This procedure, which they called "hyperphonography", involved producing pulses of 1/10th second at 1.2 MHz and immersing the upper part of the patient's head and both transducers in a water bath.

Variations in ultrasonic power passing between the transducers were recorded photographically on heat-sensitive paper as light spots. Though not displayed on a cathode-ray screen, this technique was an early attempt at scanning a human organ, and the first time we saw the use of thermal paper to display medical images.

In 1963, the first hand-held articulated arm compound contact B-mode scanner was launched in the United States, and this marked the beginning of the most popular design for static ultrasound scanners.

The analog scan converter was a significant invention in image processing and reproduction that used a silicon oxide target to display information on a standard television monitor unit. This allowed computer processor technology to be applied to the signal, allowing images to be scaled and measured on-screen with gray-scaling before being recorded on various media.

At the time, practitioners used water and oil as skin coupling agents for ultrasound transmission, however, this later changed with the development of non-staining gels, with Parker Laboratories being one of the first and biggest manufacturers of this product. Other solutions such as peel-apart Polaroid films, multi-format radiographic films, and thermal papers also became popular for ultrasound images.

Thermal Paper in a Nutshell

Ultrasound thermal paper, also known as sonography paper or ultrasound print paper, is a man-made paper that has been coated with a material that is sensitive to heat. When heat is applied, the material changes color to produce an image.

Thermal paper itself is used extensively in different areas such as in retail businesses to print labels and receipts, but also in the healthcare field to assist medical professionals in the diagnosis and treatment of various conditions.

Since ultrasound imaging works by emitting high-frequency sound waves and using their echoes to create an image, it is not recommended to use regular printing paper for ultrasound images. Regular paper lacks sensitivity to heat and cannot produce an ultrasound image, as it is commonly used for printing documents, books, magazines and other materials that do not require heat sensitivity.

In the same line, ultrasound images are typically saved in DICOM format, which is not compatible with standard printers. Specialized ultrasound printers are necessary to print these types of medical images accurately reflecting the original ones.

Image courtesy of Sony

Layers of a high-quality thermal paper

High gloss Protective coat 2 Protective coat 1 Thermal coat Synthetic paper (base material) Back coat

Advantages of Ultrasound Paper

  • Durable imaging that lasts up to 7-10 years with proper storage, making it ideal for long-term records of medical consultations.
  • Resistant to moisture and humidity.
  • Accurate ultrasound images, perfect for supporting consultation and medical training.
  • Minimal curling, smooth printing delivery, and excellent tearing properties.
  • Popular brands of ultrasound papers like Sony and Mitsubishi have smudge-free technology that prevents fingerprints.
  • Since thermal paper doesn’t require ink, it’s considered a cost-effective option that improves the printer's simplicity and durability.

Different Grades of Ultrasound Paper

Ultrasound thermal paper typically comes in three grades: standard, high-density, and high-gloss.

Standard and high-density ultrasound papers consist of back coat, yupo paper, thermal coat, and overcoat. High-density paper provides higher accuracy, sharper images, and greater detail, making it perfect for critical diagnostic and treatment plans.

Some examples of high-density papers include the Sony UPP-110HD High-Density Paper and the Mitsubishi K65HM Ultrasound Paper, and for standard prints, options like Mitsubishi K61B Ultrasound Paper or Sony UPP-110S Standard Paper are preferred by many sonographers.

Similarly, high-gloss consists of yupo paper, thermal coat, overcoat, gross coat, and head cleaning coat. This composition in layers ensures the paper's longer image durability, a polished finish and a water-resistant feature.

Reliable options for high-gloss ultrasound paper range from Sony UPP-110HG High-Gloss Paper and Sony UPP-84HG Ultrasound Paper to Mitsubishi K91HG Ultrasound Paper.

How to Choose the Right Type of Paper for Specific Imaging Purposes

Besides the grades of ultrasound paper, there are also two different types of prints: color and black & white.

Black & white ultrasound paper is mostly used by gynecologists, urologists, and radiologists for diagnostic purposes.

Grey scale comparison is crucial in black & white ultrasound images because a wide range of grey tones is required to exhibit the tonal shade of the image since subtle shades of grey indicate different densities.

Accurate reproduction of the tonal range is essential to achieve the correct grey scale of printed images. The primary goal in medical imaging is to generate an image that is realistic and accurately representative of the depicted anatomy, which is why understanding the importance of grey tones in ultrasound imaging and using the adequate solutions is critical for achieving optimal image transfer from the screen onto the paper.

On the other hand, color ultrasound paper tends to be preferred for ultrasound users dedicated to 3D/4D screening in baby ultrasound centers. High-gloss color paper produces accurate prints with exceptional detail and clarity.

Maintenance and Handling of Ultrasound Paper

Proper storage of ultrasound paper is imperative to ensure that images are preserved for a long time maintaining their quality.

According to Alliance Paper, the proper storage techniques for ultrasound paper include:

  • Keep ultrasound prints in a dark and dry area: the exposure of thermal paper to the sun and conventional fluorescent light promotes fading and yellowing on the images.
  • Maintain an average ambient temperature of less than 77°F and relative humidity less than 65%. If the paper is used continuously at temperatures of 104°F or above for more than 24 hours, pay attention to the ambient temperature and humidity to avoid compromising its quality.
  • Refrain from using adhesives containing volatile organic solvents such as alcohols, esters, ketones, as they can cause color formation. Instead, use adhesives based on starch, PVA, or CMC, as they are harmless and recommended.

Choosing the right ultrasound paper is essential in ensuring high-quality, accurate, and durable printed images. By understanding the various types of ultrasound paper, the importance of grayscale, and the proper storage techniques you will be able to not only make the right choice, but also to make the most out every thermal paper you use in your facility.

Besides choosing optimal media papers options from leading brands like Sony and Mitsubishi, it’s important to keep in mind that the device you use also needs to have frequent service and maintenance to ensure its proper calibration and reliable prints. With these tips and insights in mind, you can confidently choose the right ultrasound paper for your needs and give your patients the best ultrasound experience.