Background: Inter-societal Accreditation Commission (IAC) mandates using
specific/appropriate image acquisition for transesophageal
echocardiography (TEE). We hypothesized that an automated TEE imaging
protocol improves study efficiency and workflow compared with a manual
protocol. Methods: Three TEE disease-based protocols were included.
Image acquisition was done twice for each TEE, once each using a manual
and automated method in random order. TEE exam duration and number of
sonographer keystrokes for each method were recorded. Keystrokes were
grouped into specific categories. Multivariate analysis of variance was
performed for each variable. The same automated TEE software was used
for all automated protocol TEE exams. Results: The study included 22
patients, 14 males, ages 31-83 years, average BMI of 28.8 kg/m2
(S.D.+/-6.3). Automated protocols compared with manual protocols
significantly reduced TEE exam duration (novice, 10:59±2 vs 12:23±2 min;
expert, 8:35±1 vs 9:54±2 min, p<0.05). The protocol performed
second was shorter regardless of protocol method; however, the
percentage decrease in duration was significantly greater when the
automated protocol was performed second (27% vs 6%, p
<0.05). The automated protocol required fewer sonographer
keystrokes than the manual protocol (novice, 206±34 automated vs 287±48
manual; expert, 185±30 automated vs 254±43 manual, p<0.05).
The total number of images acquired was similar between automated and
manual protocols, without a significant difference in image quality.
Conclusion: Automated protocols improve TEE efficiency by reducing the
study duration and sonographer keystrokes regardless of TEE operator
experience and without a difference in the total number of TEE images
acquired or TEE image quality.