OP27.11: HDlive, HDliveFlow and HDliveFlow silhouette mode for the diagnosis of gestational trophoblastic disease

Abstract

We present our experience of using HDlive, HDliveFlow, and the HDliveFlow silhouette mode for the diagnosis of gestational trophoblastic disease. Five patients with complete hydatidiform mole and one with clinical invasive mole were evaluated using HDlive, HDliveFlow, and the HDliveFlow silhouette mode. In the case of an early-stage nonhydropic complete hydatidiform mole, smooth, lobulated masses were clearly recognised using HDlive, and small, irregular, cystic spaces inside the mass were also evident. In the case of a complete mole, colour Doppler showed numerous vesicles without blood vessels, while HDliveFlow with the HDlive silhouette mode clearly depicted these vesicles forming a mass with the clear demarcation of its edges, and demonstrated no blood flow inside the mass. The HDlive silhouette inversion mode clearly depicted the number, size, and spatial position of molar vesicles, compared with conventional two-dimensional(2D) sonography or the HDlive inversion mode. Moreover, spatial relationships among molar vesicles, intrauterine anechoic fluid collection, and the uterine wall enabled the clear localisation of the lesion. The HDliveFlow silhouette mode showed new visualisation of numerous small vesicles in the uterine cavity surrounded by silky vitreous-like clarity of the uterine blood flows. In the case of clinical invasive mole, abundant blood flows were clearly recognised in the posterior uterine wall using with HDliveFlow and the HDliveFlow silhouette mode. These novel techniques provide new insights, and have the potential to supplement conventional 2D sonography and colour/power Doppler ultrasound in the diagnosis of gestational trophoblastic disease.