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J Emerg Med. 2014 Jul;47(1):e5-9. doi: 10.1016/j.jemermed.2013.08.073. Epub 2013 Nov 12.

Evaluation of a cornstarch-based ultrasound gel alternative for low-resource settings.

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  • 1Department of Emergency Medicine, Alameda County Medical Center, Highland Hospital, Oakland, California.
  • 2Department of Emergency Medicine, Alameda County Medical Center, Highland Hospital, Oakland, California; Department of Emergency Medicine, University of California, San Francisco, San Francisco, California.



Ultrasound is an ideal imaging modality for low-resource settings given its portability, ease of use, and wide range of applications. Commercially available ultrasound gels may be unavailable or cost prohibitive in low-resource settings.


Our aim was to investigate the quality of images obtained with an alternative ultrasound gel made from cornstarch and water in comparison with commercially available gel.


The cornstarch gel was made by heating water and cornstarch. The gel was used to obtain standard ultrasound images of the gallbladder, kidneys, bladder, heart, and neck vessels by the study investigators. Commercial gel was used as the control. Twenty-four ultrasound clips were shown to four blinded radiologists and two ultrasound-fellowship-trained emergency department physicians. They rated the images on adequacy (yes/no) and graded the images detail, resolution, and quality using a continuous 0-10 scale.


A total of 144 video clips were shown to reviewers and 129 data-collection sheets were returned. There was no statistical difference in the proportion of images deemed to be of adequate quality: cornstarch-based gel = 0.97 (95% confidence interval [CI] 0.92-1.00) vs. commercially available gel = 0.85 (95% CI 0.75-0.94) (p = 0.053). The cornstarch gel was superior to commercial gel on all three image parameters: detail (p = 0.002), resolution (p = 0.018), and quality (p = 0.013).


In this study, a gel made from cornstarch and water was an acceptable coupling medium and provided equally adequate images as compared with commercial ultrasound gel. This inexpensive gel made from ubiquitous materials can be an acceptable alternative to commercial gel in low-resource settings.

Copyright © 2014 Elsevier Inc. All rights reserved.


cornstarch; global health; low-resource settings; ultrasound; ultrasound gel

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