3D Modalities Research Articles

First Person Bioimage: An Online Tool for Presentation and Publication of Volumetric Data

New microscopy techniques (e.g. SPIM, 3D STORM, OPT, etc.) and many other 3D bioimaging modalities (tomographic EM, MRI, CT, etc.) generate terabytes of volumetric data. Whilst highly specialized software packages are available for the analysis and visualization of such data, their use requires specialized skills and they are often costly. Furthermore the capacity to share data and allow interactive exploration by third parties is highly limited.

Skills Comparison in Pediatric Residents Using a 2-Dimensional versus a 3-Dimensional High-Definition Camera in a Pediatric Laparoscopic Simulator

Advantages in 3-dimensional (3D) laparoscopy are mostly described in adults for better depth perception, precise visualization of anatomical structures, as well as for complex surgical maneuvers in small spaces. Using Visionsense III stereoscopic endoscopy system (Neuromed Spa), we performed a comparative study between surgical skills achievements using 2-dimensional (2D) and 3D laparoscopic equipment in a pediatric laparoscopic surgery simulator model. Three skills were evaluated both in 2D and 3D modalities. Pediatric residents (n = 20) without any previous laparoscopic experience were randomly divided in 2 groups and evaluated doing the established tasks in a laparoscopic simulator validated for pediatric surgery. Switching the type of vision from 2D to 3D or vice versa, we evaluated bimanual dexterity, efficiency, and efficacy. Three tasks were proposed-task 1: transfer of objects (6 pegs transferred one-by-one on a pegboard); task 2: pattern cutting (cutting a paper, following a circular dotted line); and task 3: threading eyelet (transfer, twisting and passing through a eyelet-shaped support, a specific 3D object). Performance was measured using a scoring system rewarding precision and speed. Any physical discomfort related to the 3D vision was recorded. Of the 20 participants included, 10 began the skills in the 2D modality and then performed them in 3D, and the other 10 began in 3D and ended in 2D. Overall task 1 performance (time and number of errors) was significantly better using stereoscopic compared with monoscopic visualization. Both groups experienced a 35.6% decrease in the time needed to complete the peg transfer using 3D instead of 2D. In task 2, the 3D performance was superior (less time to correctly cut the paper along the dotted line), but did not reach statistical significance. In task 3, the residents experienced with 3D a 31.7% decrease in the time necessary to complete the passage of the object trough the eyelet. Most participants (65%) "subjectively" defined 3D laparoscopy easier overall; 6 participants (30%) did not experience any issue related to the use of 3D technology; and 1 person (5%) of group 1 found more difficulties using 3D compared with 2D. Headache (25%), nausea (20%), and visual disturbance (1%) were the most common issues reported by the students during 3D procedures. Finally, the results show that residents achieved significantly better results working with 3D vision rather than with 2D vision. As other studies have demonstrated, there was improvement in the overall performance using the 3D laparoscope. This was the first attempt to verify 3D skills in naive subjects, directly on a simulator conceived exclusively for pediatric surgery; therefore, bias was limited by using a population without surgical experience. 3D laparoscopic surgical skills showed superior to 2D, with higher percentages of tasks completion, less time in performing them, and a shorter learning curve. Our results indicate that 3D was subjectively easier than 2D in performing complex tasks in the skills laboratory setting.

Ovarian morphology in polycystic ovary syndrome: estimates from 2D and 3D ultrasound and magnetic resonance imaging and their correlation to anti-Müllerian hormone.

Background Due to improved ultrasound scanners, new three-dimensional (3D) modalities, and novel Anti-Müllerian hormone (AMH)-assays, the ultrasound criteria for polycystic ovarian morphology are under debate and the appropriate thresholds are often requested. Purpose To quantify the differences in estimates of ovarian volume and antral follicle count (AFC) from two-dimensional (2D) and 3D transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). Material and Methods A cross-sectional study on 66 overweight women with polycystic ovary syndrome (PCOS) according to Rotterdam criteria. Ovarian volume and AFC were estimated from MRI, 2D TVUS, and 3D TVUS, and serum AMH levels were assessed. Bland-Altman statistics were used for comparison. Results Participants had a median age of 29 years (age range, 19-44 years) with a mean BMI of 32.7 kg/m2 (SD 4.5). Ovarian volume from 2D TVUS was 1.48 mL (95% confidence interval [CI], 0.94-2.03; P < 0.001) and 1.25 mL (95% CI, 0.62-1.87; P < 0.001) smaller than from 3D TVUS and MRI, respectively. AFC from 2D TVUS was 18% (95% CI, 13-23; P < 0.005) and 16% (95% CI, 6-25; P < 0.005) smaller than estimates from 3D TVUS and MRI, respectively. Correlations between AMH and AFC from 2D TVUS, 3D TVUS, and MRI were 0.67, 0.78, and 0.70, respectively ( P < 0.001 for all). Conclusion In an overweight PCOS population, 2D TVUS underestimated ovarian volume and AFC as compared with 3D TVUS and MRI. Serum AMH correlated best with AFC from 3D TVUS, followed by MRI and 2D TVUS. The advantage of 3D TVUS might be of minor clinical importance when diagnosing PCOS, but useful when the actual AFC are of interest, e.g. in fertility counseling and research.

Multimodal 2D–3D face recognition using local descriptors: pyramidal shape map and structural context

In this study, the authors propose a local descriptor based multimodal approach to improve face recognition performance. Pre-processing is done to smooth, resample, and register data. The resampled three-dimensional (3D) face data are applied to extract novel descriptors including pyramidal shape index, pyramidal curvedness, pyramidal mean, and Gaussian curvatures. Proposed pyramidal shape maps are extracted at each level of the Gaussian pyramid on each point of the 3D data to have 2D matrices as representatives of 3D geometry information. A local descriptor structural context histogram, which represents the structure of the image using scale invariant feature transform, is calculated on pyramidal shape map descriptors and texture image to find matched keypoints in 3D and 2D modality, respectively. Score-level fusion by means of sum rule is employed to get a final matching score. Experimental results on the Face Recognition Grand Challenge (FRGC v2) database illustrate verification rates of 99 and 98.65% at 0.1% false acceptance rate for all versus all and ROC III experiments, respectively. On Bosphorus database, verification rate of 95.8% for neutral versus all experiment has been achieved.

Cell assisted lipotransfer in breast augmentation and reconstruction: A systematic review of safety, efficacy, use of patient reported outcomes and study quality

BackgroundCell assisted lipotransfer serves as a novel technique for both breast reconstruction and breast augmentation. This systematic review assesses the efficacy, safety and use of patient reported outcome measures in studies involving cell assisted lipotransfer. We also carry out an objective assessment of study quality focussing on recruitment, follow-up and provide an up-to-date clinical trial landscaping analysis. MethodsKey electronic databases were searched according to PRISMA guidelines and pre-defined inclusion and exclusion criteria. Two independent reviewers examined the retrieved publications and performed data extraction. Results3980 publications were identified. Following screening, 11 studies were included for full review, representing a total of 336 patients with a follow-up time ranging from six to 42 months. A degree of variation was noted in graft retention and reported satisfaction levels, although there were only three comparative studies with conflicting results. Complications occurred at a rate of 37%. Additionally, there was a paucity of objective outcomes assessments (e.g. 3D assessment modalities or validated patient reported outcome measures) in the selected studies. ConclusionsCell assisted lipotransfer is a surgical technique that is currently employed sparingly within the plastic & reconstructive surgery community. Presently, further technical and outcome standardization is required, in addition to rigorous randomized controlled trials and supporting long-term follow-up data to better determine procedural safety and efficacy. Routine use of more objective outcome measures, particularly 3D assessments and validated patient reported outcome measures, will also help facilitate wider clinical adoption and establish procedural utility.

Volumineux thrombus enclavé dans le foramen ovale au cours d’une embolie pulmonaire massive, traité avec succès par chirurgie

Paradoxical embolism is rarely demonstrated, often suggested, and the diagnosis has been largely presumptive in most cases. The patent foramen ovale (PFO) is an important predisposing anatomic factor for such a complication. We describe a case where a voluminous thrombus straddling the PFO was diagnosed by echocardiography including the 3D modality, in the setting of acute massive pulmonary embolism. The treatment is not codified in this setting, and the thrombus was successfully removed by surgery, associated with PFO closure, and anticoagulation.

Contemporary Applications of Ultrasound in Abdominal Aortic Aneurysm Management.

Ultrasound (US) is a well-established screening tool for detection of abdominal aortic aneurysms (AAAs) and is currently recommended not only for those with a relevant family history but also for all men and high-risk women older than 65 years of age. The advent of minimally invasive endovascular techniques in the treatment of AAAs [endovascular aneurysm repair (EVAR)] has increased the need for repeat imaging, especially in the postoperative period. Nevertheless, preoperative planning, intraoperative execution, and postoperative surveillance all mandate accurate imaging. While computed tomographic angiography and angiography have dominated the field, repeatedly exposing patients to the deleterious effects of cumulative radiation and intravenous nephrotoxic contrast, US technology has significantly evolved over the past decade. In addition to standard color duplex US, 2D, 3D, or 4D contrast-enhanced US modalities are revolutionizing AAA management and postoperative surveillance. This technology can accurately measure AAA diameter and volume, and most importantly, it can detect endoleaks post-EVAR with high sensitivity and specificity. 4D contrast-enhanced US can even provide hemodynamic information about the branch vessels following fenestrated EVARs. The need for experienced US operators and accredited vascular labs is mandatory to guarantee the reliability of the results. This review article presents a comprehensive overview of the literature on the state-of-art US imaging in AAA management, including post-EVAR follow-up, techniques, and diagnostic accuracy.

Probabilistic model for 3D interactive segmentation

Fully-automated segmentation algorithms offer fast, objective, and reproducible results for large data collections. However, these techniques cannot handle tasks that require contextual knowledge not readily available in the images alone. Thus, the supervision of an expert is necessary.We present a generative model for image segmentation, based on a Bayesian inference. Not only does our approach support an intuitive and convenient user interaction subject to the bottom-up constraints introduced by the image intensities, it also circumvents the main limitations of a human observer—3D visualization and modality fusion. The user “dialogue” with the segmentation algorithm via several mouse clicks in regions of disagreement, is formulated as a continuous probability map, that represents the user’s certainty to whether the current segmentation should be modified. Considering this probability map as the voxel-vise Bernoulli priors on the image labels allows spatial encoding of the user-provided input. The method is exemplified for the segmentation of cerebral hemorrhages (CH) in human brain CT scans; ventricles in degenerative mice brain MRIs, and tumors in multi-modal human brain MRIs and is shown to outperform three interactive, state-of-the-art segmentation methods in terms of accuracy, efficiency and user-workload.

Skills comparison using a 2D vs. 3D laparoscopic simulator

Abstract Background The development and application of 3D images in laparoscopic surgery has brought the benefit of in-depth perception that traditional laparoscopic surgery lacked. Previous studies in surgical populations have demonstrated the advantages of 3D technology. To limit bias of the previous experiences of participants, this study was performed in a population without any experience in this area. Material and methods An experimental, open, cross-sectional, comparative study between surgical skills achievements using 2D and a 3D laparoscopy equipment, using each subject as their own control. Six skills were evaluated in 2D and 3D modalities. Results Of the 40 participants included, 20 began the skills in the 2D modality and then performed them in 3D, and the other 20 began in 3D. Of the 118 skills evaluated there was a time improvement in 72% in the 3D group compared to 37% in the 2D modality. The accomplishment percentage using the 3D laparoscopy was greater for both groups. There was a statistically significant difference in the better time for the 3D performed tasks. Just over half (52.5%) of participants preferred 3D laparoscopy, 15% preferred 2D, and 32.5% had no preferences. Discussion As other studies have demonstrated, there was improvement in the overall performance using the 3D laparoscope. Bias was limited by using a population without surgical experience. Conclusions 3D laparoscopic surgical skills showed superior to 2D, with higher percentages of tasks completion, less time in performing them, and a shorter learning curve.

Lung-On-A-Chip Technologies for Disease Modeling and Drug Development

Animal and two-dimensional cell culture models have had a profound impact on not only lung research but also medical research at large, despite inherent flaws and differences when compared with in vivo and clinical observations. Three-dimensional (3D) tissue models are a natural progression and extension of existing techniques that seek to plug the gaps and mitigate the drawbacks of two-dimensional and animal technologies. In this review, we describe the transition of historic models to contemporary 3D cell and organoid models, the varieties of current 3D cell and tissue culture modalities, the common methods for imaging these models, and finally, the applications of these models and imaging techniques to lung research.

Efficient multi-temporal hyperspectral signatures classification using a Gaussian-Bernoulli RBM based approach

This paper presents an efficient Gaussian-Bernoulli Restricted Boltzmann Machines (GB-RBM) framework in order to better address the classification challenge of remotely sensed images. The proposed approach relies on generating well-designed features for a new 3D modality of spectral signature. For this purpose, mesh smoothing is introduced to reduce noise while conserving the main geometric features of the multi-temporal spectral signature. Then, we propose the use of an RBM (Restricted Boltzmann Machine) framework as stand-alone non-linear classifier. The adapted framework focuses on a cooperative integrated generative-discriminative objective allowing the integration of modeling input features and their classification process in one-pass algorithm. The main benefit of the proposed approach is the ability to learn more discriminative features. We evaluated our approach within different scenarios and we demonstrated its usefulness for noisy high dimensional hyperspectral images.

Non-consultant hospital doctors in Ireland; A survey of satisfaction in training

Non-consultant hospital doctors in Ireland; A survey of satisfaction in training

Comparación de destrezas en simulador de laparoscopia: imagen en 2D vs. 3D

BackgroundThe development and application of 3D images in laparoscopic surgery has brought the benefit of in-depth perception that traditional laparoscopic surgery lacked. Previous studies in surgical populations have demonstrated the advantages of 3D technology. To limit bias of the previous experiences of participants, this study was performed in a population without any experience in this area. Material and methodsAn experimental, open, cross-sectional, comparative study between surgical skills achievements using 2D and a 3D laparoscopy equipment, using each subject as their own control. Six skills were evaluated in 2D and 3D modalities. ResultsOf the 40 participants included, 20 began the skills in the 2D modality and then performed them in 3D, and the other 20 began in 3D. Of the 118 skills evaluated there was a time improvement in 72% in the 3D group compared to 37% in the 2D modality (P=.000). The accomplishment percentage using the 3D laparoscopy was greater for both groups. There was a statistically significant difference in the better time for the 3D performed tasks. Just over half (52.5%) of participants preferred 3D laparoscopy, 15% preferred 2D, and 32.5% had no preferences. DiscussionAs other studies have demonstrated, there was improvement in the overall performance using the 3D laparoscope. Bias was limited by using a population without surgical experience. Conclusions3D laparoscopic surgical skills showed superior to 2D, with higher percentages of tasks completion, less time in performing them, and a shorter learning curve.

SU‐E‐T‐742: The Risk of Secondary Malignancies as An Evaluation Factor in the Comparison of Prostate Cancer Intensity Modulated Radiotherapy (IMRT) and Conformal Radiotherapy (CRT) Treatment Plans

Purpose:To examine the clinical efficacy of both MLC‐based IMRT, and 3D‐Conformal Radiation Therapy modalities (CRT) to treat prostate cancer using radiobiological measures. Furthermore, to investigate the risk for developing secondary malignancies in bladder and rectum due to radiotherapy from the corresponding modalities.Methods:Treatment plans for prostate cancer were developed using IMRT and CRT for ten patients. For the IMRT plans, two different treatment protocols were used (RTOG and FCCC). For the evaluation of these plans, the complication‐free tumor control probability, the total probability of injury, the total probability of control/benefit, and the biologically effective uniform dose were employed. Furthermore, based on the dosimetric data of IMRT and CRT, the risk for secondary malignancies was calculated for bladder and rectum.Results:The average risk for secondary malignancy was lower for the bladder (0.37%) compared to the rectum (0.81%) based on all the treatment plans of the ten prostate cancer patients. The highest average risk for secondary malignancy for bladder and rectum was for the 6X 3D modality (0.46% and 1.12%, respectively) and the lowest was for the 18X IMRT RTOG modality (0.33% and 0.56%, respectively). The response probability was lower for the bladder than for the rectum in all the plans. For the bladder the highest value was for the 18X IMRT FCCC (0.03%) and the lowest was for the 18X 3D modality (0.0%). For the rectum, the highest value was for the 6X IMRT RTOG (3.52%) and the lowest was for the 18X IMRT FCCC modality (0.41%).Conclusion:By using radiobiological measures it is shown that the IMRT FCCC plans had the lowest risks for normal tissue complications, whereas the IMRT RTOG had the highest. Regarding the risk for secondary malignancies, the CRT plans showed the highest values both in bladder and rectum.

Prospective trial of breast MRI versus 2D and 3D ultrasound for evaluation of response to neoadjuvant chemotherapy.

Preoperative imaging to assess response to neoadjuvant chemotherapy in breast cancer is routine but no single imaging modality is standard of practice. Our hypothesis is that ultrasound (US) is comparable to magnetic resonance imaging (MRI) in the prediction of residual disease. A single-institution, Institutional Review Board-approved prospective trial of primary invasive ductal breast cancer patients receiving neoadjuvant chemotherapy enrolled women from 2008 to 2012. Two-dimensional (2D) and three-dimensional (3D) US, as well as MRI images of pre- and post-neoadjuvant tumors were obtained. Skin involvement or inadequate images were excluded. Residual tumor on imaging was compared with surgical pathology. Differences of tumor volume on imaging and pathology were compared using the non-parametric Wilcoxon signed-rank test. US to MRI agreement was determined by the kappa coefficient. Tumor volumes in estrogen receptor (ER), progesterone receptor (PR), and Her2neu subgroups were compared using the Kruskal-Wallis test. ER/PR staining <5 % was considered negative; Her2neu status was determined by in situ hybridization. Forty-two patients were enrolled in the study; 39 had evaluable post-treatment data. Four patients were Her2neu positive, and 17 (46 %) patients had triple-negative tumors. Among 11 (28 %) patients with pathologic complete response (pCR), US correctly predicted pCR in six (54.5 %) patients compared with eight (72.7 %) patients when MRI was used. This is a substantial agreement between US and MRI in predicting pCR (kappa = 0.62). There was no difference between 2D and 3D US modalities. For the 39 patients, US and MRI had no significant difference in volume estimation of pathology, even stratified by receptor status. The estimation of residual breast tumor volume by US and MRI achieves similar results, including prediction of pCR.

2D vs 3D visualization modalities and their effects on motor related potentials

2D vs 3D visualization modalities and their effects on motor related potentials

Utilization of Real-time 3D Transesophageal Echocardiography in an Urban Academic Medical Center

Purpose: Real-time three-dimensional transesophageal echocardiography (3D TEE) is useful in a variety of clinical scenarios. However, the pattern of its clinical utilization in an urban academic center is unknown. The objective of this study is to evaluate the practical use of 3D TEE and to explore factors that may affect its applications. Methods: We conducted a retrospective study by reviewing 2,734 consecutive TEEs performed at Montefiore Medical Center in Bronx, NY, between January 2009 and August 2011. Types of 3D modes (biplane, live, 3D zoom, full volume, and 3D quantifi cations) and indications were reviewed. Linear regression was performed to examine the association between echocardiographers & rsquo; characteristics and 3D TEE utilization. Results: 3D modalities were utilized in 1,655 studies (61%) during the study period. The use of 3D technology increased from 44% at 4 months to 79% at 32 months. Biplane, 3D zoom, and full volume acquisition showed a steady increase, but quantification remained very low throughout the study period. Level 3 training was significantly associated with 66.6% (95% CI 13.0%, 120.1%, P = 0.029) higher rate of 3D TEE utilization compared to level 2, after adjusting for age, sex, years of practice, and total TEE volume. Level 3 echocardiographers utilized more zoom 3D and full volume, whereas level 2 echocardiographers used biplane more frequently. Conclusion: There has been a growing use of 3D TEE over time, but not all 3D modes were equally employed. The association between advanced training and increased 3D utilization is likely due to interest and self-motivation. Key words: Echocardiographer, echocardiography, real-time three-dimensional transesophageal echocardiography.

Screening for prevention of cardiovascular complications in sports: the challenge going forward

E-mail: alexander.kisko@unipo.sk The three main features requested for the ideal pre-participation screening (PPS) in sports are cost-effectiveness, high diagnostic accuracy and feasibility in large populations. Controversy exists concerning increasing an efficacy of the PPS by using echocardiography (ECHO). 500 healthy athletes (aged: 16-32, median age 21 ± 5, 446 males and 54 females [8:1], participating in sports like football, athletics, handball, cycling, basketball, gymnastics) were examined during the period from 2011-2013 in a pilot study focusing on the prevention of cardiovascular complications in sports. All of the athletes were screened according to European PPS protocol with history taking, physical examination and 12-lead ECG registration. Cardiovascular abnormalities were not detected in any case. After that conventional ECHO (M-mode and 2D modalities) the exam was performed in all of the athletes and a broad spectrum of cardiovascular abnormalities was found in 14 cases (2.8%). In 7 (1.4%) athletes it was mitral valve prolapse (hemodynamically significant in 1 case), in 3 (0.6%) — bicuspid aortic valve (significant aortic stenosis in 1 case) and in other 4 cases (0.8%) it was myocarditis, myocardial bridging, noncompaction of the left ventricle and coronary artery fistula. In 4 athletes abnormalities that were found required a temporary or permanent sports activities cessation. The postulate suggesting that inclusion of ECHO into the PPS protocol may not be cost-effective should be revised today. Currently conventional techniques like M-mode and 2D are inexpensive enough (about 6.00 Euros in Slovakia), technically simple to be performed in the field in large athletic population by pocket-size ultrasound systems, powerful enough for the efficient screening and thus hold the potential to enter a screening protocol. Well-constructed, sufficiently powered, randomized and long-term controlled studies will allow an objective evaluation of ECHO contribution to the diagnostic evaluation of life-threatening cardiovascular abnormalities in athletes. Considering such evidence, a modified PPS protocol should probably be applied to the sports cardiology practice.

Radiological assessment of breast density by visual classification (BI–RADS) compared to automated volumetric digital software (Quantra): implications for clinical practice

This study was done to assess breast density on digital mammography and digital breast tomosynthesis according to the visual Breast Imaging Reporting and Data System (BI-RADS) classification, to compare visual assessment with Quantra software for automated density measurement, and to establish the role of the software in clinical practice. We analysed 200 digital mammograms performed in 2D and 3D modality, 100 of which positive for breast cancer and 100 negative. Radiological density was assessed with the BI-RADS classification; a Quantra density cut-off value was sought on the 2D images only to discriminate between BI-RADS categories 1-2 and BI-RADS 3-4. Breast density was correlated with age, use of hormone therapy, and increased risk of disease. The agreement between the 2D and 3D assessments of BI-RADS density was high (K 0.96). A cut-off value of 21% is that which allows us to best discriminate between BI-RADS categories 1-2 and 3-4. Breast density was negatively correlated to age (r = -0.44) and positively to use of hormone therapy (p = 0.0004). Quantra density was higher in breasts with cancer than in healthy breasts. There is no clear difference between the visual assessments of density on 2D and 3D images. Use of the automated system requires the adoption of a cut-off value (set at 21%) to effectively discriminate BI-RADS 1-2 and 3-4, and could be useful in clinical practice.

Comparison of different computed tomography post-processing modalities in assessment of various middle ear disorders

Several anatomic structures of the middle ear are not optimally depicted in the standard axial and coronal planes. Several 2D and 3D image-processing modalities are currently available for CT examinations in clinical radiology departments. Till now 3D reconstructions of the temporal bone have not been widely used yet, and attracted only academic interest. The aim of this study was to compare axial (source images), 2D and 3DCT post-processing modalities, and to evaluate the value of 3D reconstructed images/virtual endoscopy (VE) in assessment of various middle ear disorders for identification of the best modality/view for assessment of a particular middle ear structure or pathology. 40 patients with various middle ear disorders, planned for surgical intervention were included in prospective study. Multi-slice CT was performed for all patients. Scans were acquired in the axial plane. The axial source datasets were utilized for generation of 2D reformations and 3D reconstructed images. All studied images were divided into three categories: axial (source images), 2D reformations (MPR and sliding-thin-slab MIP) and 3D reconstruction (virtual endoscopy). The visibility of middle ear structures and pathologies with each modality were scored qualitatively using three-point scoring system in reference to operative findings. Stapes superstructure and footplate, incudostapedial joint, oval and round windows, tympanic segment of the facial nerve and tegmen were not optimally depicted in the axial plane. Sinus tympani and facial recess were best visualized with axial images or VE. 3D reconstruction/VE allowed good visualization of all parts of ossicular chain except stapes superstructure. Regarding pathologic changes, 2D reformations and 3D reconstructed images allowed better visualization of erosion of ossicles and tegmen. 3D reconstruction/VE did not allow detection of foci of otospongiosis. 2D reformations can be considered the mainstay in assessment of most middle ear structures and pathologies. 3D reconstruction/VE seems to provide a useful method for a preoperative general overview of the middle ear anatomy, particularly for the ossicular chain, round window and retrotympanum.