 Hi, my name is Vishal Kumar, I hail from Nasek. This is my peripheral centre at Ikatpuri. My expertise are ultrasound and guided intervention. Today, my first topic is panoramic view and its advantages. So, I will be speaking on the practical aspects of panoramic view and how it is taking. Okay, I will just do a panoramic view of a normal thyroid from right to left. Incidentally, this lady has multiple right-side cervical nodes also. Okay, we will just try and take a nice panoramic view. Just look at my hand as I graze through. Okay, this panoramic was not complete because one important thing I did not do in this view was cover the entire area with a good jelly bath. I am doing it again, just doing the horizontal thyroid clip again. If you can see well, the entire thyroid has been covered and the part which was not seen in the last clip is well seen because I have used lot of jelly bath and good opposition on the left side too. This is my second patient, this is the male patient. We have done the ultrasound before for this patient and we got a working diagnosis of dendritic mastitis in the left cervical region. I will just try to show you, in this case, can we get a good panoramic view to show the entire involvement of the disease around the subareolar region. Okay, I will just try to slide my probe with the use of good jelly bath. So, here we have a nice picture of dendritic mastitis and the tentacles which are shown and everything is seen in one image with the help of panoramic view. So, this view can be helpful in any kind of pathologies. Only thing learning point here is whenever there is a bump or an irregular surface, you use lot of jelly to counter it so that you get a smoothness. This is case 3, this is an interesting case where there is an abnormal node which is very close to the submandibular gland and it has calcifications and is close to the carotid vessels also. Okay, this is the second view I have taken for this patient. The first view we had multiple broken lines in the panoramic view. So, I tried to correct it. What I did was I took some extra jelly and the jelly bath created on the node was around half a centimeter and when I used my probe and locked it downstairs and it was in a smooth manner without any jerky movements. So, I got a very clear image where the submandibular gland, the node and the carotid are seen very clearly. We have seen that we have done panoramic views with the linear probes of different frequencies. I want to state that we can do panoramic views for large lesions in the abdomen using the convex probe too. So, even if you have a low frequency convex probe, you still can do a panoramic view for a large lesion. I will just show you how. Okay, so we have a good panoramic view taken here. I will just show what is what. This is the liver, this is the aorta, these are the bowel loops with gas within and these are the branches of the aorta in the inguinal region. So, we have covered you can say approximately 20 to 25 centimeters of the abdomen using the panoramic view. So, what is the learning point here is even in large abdominal lesions like ovarian masses or misandroxists, we can show the relation with adjacent organs using the panoramic view. This technique is used to measure objects or masses which are larger than the field of view by stitching the images together, gives large field of view by sliding the transducer across organ surface by adding new data to the existing one. Panoramic imaging broadens the scope of spatial relations, thereby sequentially aligning individual images in their anatomical content. This has the ability to display an entire abnormality and show its relation to the adjacent structure in a single static image. It is also one of the key technologies used in widening the field of view for medical ultrasound images, clinical diagnosis and measurements. Two-dimensional ultrasound panoramic view has been prevalent in routine practices including precise measurement and tracing, the tubular structures in abdomen, distant measurement in phantom studies, detection of muscle tears, visualization of musculoslegament tissues, structures of the neck and the anatomical structure in obstetrics. One of the prerequisites for having a panoramic view, you have to check whether you have the software in your machine or not, select your patient wisely. Difficult patients with bumpy areas you will be having a hard time doing a panoramic view. Best results are obtained with linear probe, connex probe can also be used for such cases. The most important technique which I use is a stable and gentle hand, good jelly bath for bumpy lesions or where there is lesion, there is acute or obtuse angles and scanning movement should be smooth. Some people prefer scanning slowly, some prefer doing it fast like me, but whatever movement should do have to be smooth, post-processing possible in high end machines. I will just sequentially tell you how a panoramic image is obtained, position the probe along the long axis of the lesion with copious jelly interface, go in the panoramic mode and start the software, move your hand in a non-jerky fashion along the desired lesion, preferably go in a single smooth movement without stopping the probe, take complete acquisition with pre-desired endpoint, post-processing if required can be done and yes you have a perfect panoramic image. Copious jelly bath is very important when you are dealing with difficult areas and areas which are not smooth or tubular, thank you.