Many endocavity ultrasound users do not have access to infection prevention guidelines, according to a survey study published February 28 in Ultrasound in Medicine & Biology.
A team led by Susan Westerway, PhD, from Charles Sturt University in Sydney, Australia, also reported that most ultrasound users do not have access to training in using their chosen transducer cleaning and disinfection methods. The results come from a survey issued by the World Federation for Ultrasound in Medicine and Biology (WFUMB) Safety Committee.
“Inadequate reprocessing of endocavity ultrasound transducers increases the possibility of transmission of bacteria and viruses, such as human papillomavirus and HIV, and puts patient safety at risk,” the Westerway team wrote.
The WFUMB in 2024 published updated recommendations for cleaning endocavity ultrasound transducers between exams. These exams could be transvaginal, transrectal, or oral cavity, each of which has risk factors for cross-contamination between patients and ultrasound users. Probe covers alone do not prevent cross-contamination, since they can split during an endocavity exam.
Despite evidence, the researchers noted persistent reluctance by some ultrasound users in adjusting their cleaning practices.
Westerway and colleagues explored the international availability of practice guidelines, training, and methods used for reprocessing endocavity ultrasound transducers after scanning. The survey issued by the researchers included questions regarding the use of transducer covers for endocavity ultrasound exams, the availability of infection prevention guidelines, and the availability of training in this area, among others.
Final analysis included responses from 1,436 respondents from 105 countries. The researchers reported the following findings:
About 37% of respondents said they have access to guidelines for infection prevention and control, and 57% said they were unsure of any available guidelines in their practice.
About 46% of practitioners reported receiving training in reprocessing endocavity transducers after use.
About 94% reported using probe covers when performing an endocavity ultrasound exam.
About 40% of respondents said they prefer using high-level disinfection after using probes. Another 18% said they use a surface wipe such as alcohol, detergent, or bleach after removing probe covers and gel.
The study authors reiterated that probe covers alone should not be a substitute for high-level disinfection. They added that manufacturer instructions for cleaning and disinfection should be followed and that facilities should make sure that the cleaning product used is compatible with the ultrasound transducer.
“With the growing evidence of infection transmission following endocavity ultrasound examinations, Ministries of Health, guided by their relevant [infection prevention and control] groups and ultrasound societies, should be encouraged to endorse the implementation of, and training in infection prevention in ultrasound practice, and to recommend the use of high-level disinfection following any endocavity ultrasound examination,” they wrote.
Read the full study here.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
