Due to the absorption of ultrasound, heating of tissue (including bone) can occur. For this reason, the sonographer should follow the ALARA principle to minimize the potential for ultrasonic heating of tissue during for example M-mode ultrasound. The thermal effect of Doppler ultrasound flow examinations is significantly greater.

See also Thermal Index and Ultrasonic Power.

The main advantage of ultrasound is that certain structures can be observed without using radiation. However, ultrasound is energy and there are ultrasound safety regulations, because two bioeffects of ultrasound are heat and cavitation. Ultrasound is a mechanical energy in which a pressure wave travels through tissue. Reflection and scattering back to the transducer are used to form the image. As sound energy is transmitted through the tissue, some energy is reflected and some power is absorbed.
Possible physical effects with ultrasound:
The ultrasound safety is based on two indices, the mechanical index (MI) and the thermal index (TI). The WFUMB guidelines state that ultrasound that produces temperature rises of less than 1.5°C may be used without reservation. They also state that ultrasonic exposure causing temperature rises of greater than 4°C for over 5 min should be considered potentially hazardous. This leaves a wide range of temperature increases which are within the capability of diagnostic ultrasound equipment to produce and for which no time limits are recommended. However, it has not been determined that medical ultrasound causes any adverse reaction or deleterious effect.
The American Institute of Ultrasound in Medicine states that as of 1982, no independently confirmed significant biologic effects had been observed in mammalian tissue below (medical usage) 100mW/cm2.

See also Ultrasound Regulations and Ultrasound Radiation Force.

Ultrasound therapy uses high energy sound waves to treat different diseases. Historically, the use of ultrasonic waves in therapy began before the wide use as a diagnostic medical imaging tool. Dependend on the intensity, ultrasound therapy reach from the thermal effect used in physical therapy to the destruction of tissue with lithotripsy.

Types of ultrasound treatment:
See also Thermal Index, History of Ultrasound, Interventional Ultrasound, and B-Mode Acquisition and Targeting.