Abstract
Conventional ultrasound (US) is the first-line imaging method for abdominal pathologies, but its diagnostic accuracy is operator-dependent, and data storage is usually limited to two-dimensional images. A novel tomographic US system (Curefab CS, Munich, Germany) processes imaging data combined with three-dimensional spatial information using a magnetic field tracking. This enables standardized image presentation in axial planes and a review of the entire examination. The applicability and diagnostic performance of this tomographic US approach was analyzed in an abdominal setting using conventional US as reference. Tomographic US data were successfully compiled in all subjects of a training cohort (20 healthy volunteers) and in 50 patients with abdominal lesions. Image quality (35% and 79% for training and patient cohort respectively) and completeness of organ visualization (45% and 44%) were frequently impaired in tomographic US compared to conventional US. Conventional and tomographic US showed good agreement for measurement of organ sizes in the training cohort (right liver lobe and both kidneys with a median deviation of 5%). In the patient cohort, tomographic US identified 57 of 74 hepatic or renal lesions detected by conventional ultrasound (sensitivity 77%). In conclusion, this study illustrates the diagnostic potential of abdominal tomographic US, but current significant limitations of the tomographic ultrasound device demand further technical improvements before this and comparable approaches can be implemented in clinical practice.
Highlights
Ultrasound is the first line method for detection and characterization of abdominal pathologies, especially focal lesions in screening and follow-up scenarios [1]
The review of the conventional US video information by the reference examiner confirmed seven of these lesions (n = 2 liver, n = 7 kidney), whereas 15 putative lesions (n = 6 liver, n = 9 kidney) could not be verified. This is the first report on the diagnostic value of a magnetic field tomographic US for the evaluation of abdominal pathologies
Our pilot data demonstrate the diagnostic potential of tomographic US, and indicate relevant limitations of the current technology
Summary
Ultrasound is the first line method for detection and characterization of abdominal pathologies, especially focal lesions in screening and follow-up scenarios [1]. The diagnostic value of conventional ultrasound is highly operator-dependent. The documentation of ultrasound examinations is traditionally performed in poorly standardized two-dimensional images [2,3,4]. This neither permits a retrospective review of the entire examination nor allows a sufficient comparison with radiological imaging (computed tomography, CT; magnetic resonance imaging, MRI).
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