HDlive Silhouette Mode Research Articles

EP19.10: HDliveFlow silhouette mode with HDlive silhouette mode for diagnosis of sclerosing stromal tumour of the ovary

We present our experience of using the HDliveFlow silhouette mode with HDlive silhouette mode to diagnose sclerosing stromal tumour (SST) of the ovary. Two-dimensional (2D) sonography showed an echogenic solid tumour with some anechoic areas inside the mass. Two-dimentional power Doppler depicted peripheral vascularity with a few cental vessels inside the mass. HDliveFlow clearly showed abundant peripheral vascularisation with several penetrating vessels (scrubbing-brus appearance). The HDliveFlow silhouette mode with HDlive silhouette mode revealed numerous peripheral vessels with some penetrating vessels and a few cysts inside the mass. MRI was highly suggestive of SST. Laparoscopic right salpingo-oophorectomy was performed, and the histopathologic diagnosis was SST of the right ovary. The HDliveFlow silhouette mode with HDlive silhouette mode may facilitate the preoperative diagnosis of SST as an additional diagnostic tool along with conventional 2D power Doppler sonography. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

HDlive Flow with HDlive silhouette mode in diagnosis of molar pregnancy.

HDlive Flow with HDlive silhouette mode in diagnosis of molar pregnancy.

HDliveFlow with HDlive Silhouette Mode for Diagnosis of Persistent Right Umbilical Vein and Single Umbilical Artery

HDliveFlow with HDlive Silhouette Mode for Diagnosis of Persistent Right Umbilical Vein and Single Umbilical Artery

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

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.

HDliveFlow with HDlive Silhouette Mode for Diagnosis of Malignant Tumors of Uterine Cervix

ABSTRACT Objective To present our experience of using HDliveFlow with the HDlive silhouette mode to assess malignant tumors of the uterine cervix. Materials and methods Five women with malignant tumors of the uterine cervix (one case each of malignant lymphoma, cervical cancer stage IIA, and three of cervical cancer stage IVb) were studied using HDliveFlow with the HDlive silhouette mode. Results In a case of malignant lymphoma of the cervix, HDliveFlow with the HDlive silhouette mode demonstrated a markedly hyper-vascularized uterus with numerous vessels radiating out from the periphery of the uterus to its center (radialvascular pattern). In four cases of advanced cervical cancer (one case each of stage IIA, and three of stage IVb), HDliveFlow with the HDlive silhouette mode revealed a central hyper-vascular tumor within the peripheral vascular-ring appearance of the cervix, and clearly demonstrated the configuration of the tumor. Conclusion HDliveFlow with the HDlive silhouette mode may provide useful information on the diagnosis of malignant tumors of the uterine cervix. How to cite this article Tanaka T, AboEllail MAM, Ishimura M, Yamamoto K, Ishibashi M, Mori N, Kanenishi K, Hata T. HDliveFlow with HDlive Silhouette Mode for Diagnosis of Malignant Tumors of Uterine Cervix. Donald School J Ultrasound Obstet Gynecol 2016;10(4):409-412.

Fetal Facial Abnormalities: From 2D Sonography to HDlive and HDlive Silhouette Mode

ABSTRACT Fetal face examination is essential to complete a full anatomical scan. Two-dimensional (2D) sonography is the basic standardized tool used. The anatomical nature of the fetal face should be accurately judged along with the exclusion of all possible anomalies, but this is sometimes difficult to achieve with 2D sonography alone. Three-dimensional (3D) ultrasound provides detailed data on the fetal face. Many studies showed its superiority for detecting anomalies that were missed by 2D sonography. HDlive provides life-like images of the fetal face, and the HDlive silhouette mode provides hologram-like images of structures of interest. In this article, the development of ultrasound from 2D to conventional 3D and new rendering modes, such as HDlive and the HDlive silhouette mode will be presented, highlighting studies comparing the benefits and advantages of each of these new techniques over conventional 2D sonography for detecting fetal facial anomalies. How to cite this article Sajapala S, AboEllail MAM, Kanenishi K, Hata T. Fetal Facial Abnormalities: From 2D Sonography to HDlive and HDlive Silhouette Mode. Donald School J Ultrasound Obstet Gynecol 2016;10(3):313-320.

HDlive Flow Silhouette Mode for the Diagnosis of Uterine Sarcoma

ABSTRACT We present our initial experience of using the HDlive Flow silhouette mode to construct an image of uterine sarcoma. Two-dimensional sonography showed a heterogeneous uterine mass with central, irregular cystic areas. The HD-flow demonstrated only peripheral vascularities around the mass. However, the HDlive Flow silhouette mode with HDlive silhouette mode clearly depicted abnormal penetrating vessels from peripheral vessels in the mass. The HDlive Flow silhouette mode provides a novel, unique sonographic appearance of uterine sarcoma, and may facilitate its diagnosis and localization of abnormal blood vessels in the mass. How to cite this article Hata T, Kanenishi K, Tanaka T, Ito M, Mori N. HDlive Flow Silhouette Mode for the Diagnosis of Uterine Sarcoma. Donald School J Ultrasound Obstet Gynecol 2017;11(4):259-260.

Recent Advances in 3D Ultrasound, Silhouette Ultrasound, and Sonoangiogram in Fetal Neurology

ABSTRACT New fields of neurosonoembryology and fetal neurology have been established by the remarkable contribution of threedimensional/ four-dimensional (3D/4D) ultrasound technology. A recent evolution in prenatal imaging is HDlive silhouette/flow technology. By HDlive silhouette mode, an inner cystic structure with fluid collection can be depicted through the outer surface structure of the body, and it can be appropriately named “seethrough fashion.” HDlive flow mode adds more spatial resolution to conventional 3D ultrasound angiogram. We have utilized this technology in neuroimaging and investigated its clinical significance. HDlive silhouette imaging demonstrated clear images of ventricular system with outer fetal surface structure in early pregnancy as well as in the middle gestation. Silhouette ultrasound demonstration of a thick slice of 3D volume dataset shows a more concrete inside structure of complicated morphology in specific cases. Silhouette ultrasound can also depict a bony structure; therefore, cranial bones and vertebrae of spina bifida can be detected using this technology. HDlive flow imaging can demonstrate the cerebral vascular structure of fine arteries and veins throughout gestation. By HDlive silhouette and flow imaging, inner cystic as well as noncystic structures can be demonstrated with outer surface. HDlive flow imaging can demonstrate fine peripheral brain vasculature. The degree of gain, threshold, and silhouette or a combination of these makes it possible to create completely different images with different clinical information from a single-volume dataset. This fact expands the flexibility of imaging and demonstration, but at the same time it can create a virtual reality. Although any new technology is not always perfect, HDlive silhouette and flow imaging will greatly contribute to perinatal medicine. How to cite this article Pooh RK. Recent Advances in 3D Ultrasound, Silhouette Ultrasound, and Sonoangiogram in Fetal Neurology. Donald School J Ultrasound Obstet Gynecol 2016;10(2):193-200.

HDlive Silhouette Mode With Spatiotemporal Image Correlation for Assessment of the Fetal Heart.

The purpose of this article is to present our experience with normal and abnormal fetal cardiac structures reconstructed in the HDlive silhouette mode (GE Healthcare Japan, Tokyo, Japan) with spatiotemporal image correlation (STIC). Twenty-two fetuses with normal hearts and 1 fetus with a congenital heart anomaly (Ebstein anomaly) at 20 to 36 weeks' gestation were studied in the HDlive silhouette mode with STIC. In normal fetal hearts, 4 cardiac chambers and crisscross arrangements of the pulmonary artery and aorta were clearly identified. This modality facilitated visualization of the relationships and course of the outflow and inflow tracts, thus helping the operators more effectively understand the spatial relationships among the cardiac chambers and vessels. The opening and closing of mitral, tricuspid, pulmonary, and aortic valves were ascertained in the en face view of both atrioventricular valves and great vessels. In the fetus with Ebstein anomaly, a low attachment of the tricuspid valve and an enlarged right atrium were evident. The HDlive silhouette mode with STIC provides new visual experiences for physicians, owing to the anatomically clear depiction of fetal cardiac structures, and it may be an easier way to depict the spatial relationships among fetal cardiac chambers, great arteries, and veins.

Novel Application of HDlive Silhouette and HDliveFlow: Clinical Significance of the ‘See-through Fashion’ in Prenatal Diagnosis

ABSTRACT Owing to prenatal ultrasound technology, there has been an immense acceleration in understanding of early human development. Recent advanced three-dimensional (3D) technology has produced exciting new applications of high-definition live (HDlive) silhouette and HDliveFlow imaging. By HDlive silhouette mode, an inner cystic structure with fluid collection can be depicted through the outer surface structure of the body and it can be appropriately named as see-through fashion’. Additionally, HDlive silhouette can depict hyperechoic structures, such as bones because skeletal system is demonstrated by ultrasound as conspicuously echogenic organs. HDliveFlow imaging adds more spatial resolution to conventional 3D ultrasound angiogram. HDliveFlow imaging demonstrates fine peripheral blood vessels, such as vascularity of the lung, brain and eyeballs. HDliveFlow combined with silhouette mode demonstrates the accurate location of vascularity inside organs. Simultaneous visualization of both structure and vascularity is quite comprehensive and may add further clinical information of vascularization. Thus, ‘see-through fashion’ imaging technology provides us comprehensive orientation and persuasive localization of inner morphological structure as well as of angiostructure inside the fetal organs. HDlive silhouette and flow imaging add further clinical significance to conventional three/four-dimensional (3D/4D) imaging in fields of sonoembryology and neurosonology, and may open up a new field of sono-ophthalmology. Owing to novel applications with clinical significance, fetal ultrasound is at present noninvasive, direct-viewing of the embryo/fetus, and all-inclusive technology, and is definitely the first modality of prenatal diagnosis with infinite potential. How to cite this article Pooh RK. Novel Application of HDlive Silhouette and HDliveFlow: Clinical Significance of the ‘Seethrough Fashion’ in Prenatal Diagnosis. Donald School J Ultrasound Obstet Gynecol 2016;10(1):90-98.

First Trimester Scan by 3D, 3D HDlive and HDlive Silhouette/Flow Ultrasound Imaging

ABSTRACT Both three-dimensional (3D) and four-dimensional (4D) ultrasound have improved our knowledge regarding the development of the embryo and fetus and of a great number of fetal anomalies. The great achievement in the field of 3D/4D ultrasound is HDlive technology. This technology is a novel ultrasound technique that improves the 3D/4D images. Furthermore, recent advanced 3D technology has produced exciting new applications of HDlive silhouette and HDlive flow. The algorithm of HDlive silhouette creates a gradient at organ boundaries where an abrupt change of the acoustic impedance exists within tissues. By HDlive silhouette mode, an inner cystic structure with fluid collection can be depicted through the outer surface structure of the body, and it can be appropriately named as ‘see-through fashion’. Close observation of small embryos and fetuses by advanced 3D technology in early gestation allows us to make diagnoses of various abnormalities. Novel imaging techniques are illustrated in the definition of normal embryonic anatomy as well as in the identification of many of congenital anomalies. Prenatal ultrasound has established sonoembryology and neurosonology, and advnanced HDlive and HDlive silhouette and flow imaging added further clinical significance to conventional 3D/4D imaging in those fields. They allow extending the detection of anatomical congenital anomalies to an earlier gestational age, and it is beyond description that noninvasive viewing of the embryo/fetus by all—inclusive ultrasound technology is definitely the first modality in a field of prenatal diagnosis, and help our goal of proper perinatal care and management. How to cite this article Pooh RK. First Trimester Scan by 3D, 3D HDlive and HDlive Silhouette/Flow Ultrasound Imaging. Donald School J Ultrasound Obstet Gynecol 2015;9(4):361-371.

Fetal HDlive Silhouette Mode in Clinical Practice

ABSTRACT Many rendering modes and types of software have been introduced as tools to aid in the prenatal detection of fetal anomalies. They aim at facilitating the diagnosis, increasing physicians’ confidence, and achieving a better understanding of these anomalies. The HDlive silhouette mode is a novel technology, which provides vitreous-like clarity of the fetus and placenta. Through using a shadowing effect, the outlines of structures of interest can be delineated clearly with a simultaneous display of the inner core and structure. It is more beneficial for identifying a normal anatomy and diagnosing complex congenital malformations. Moreover, the shadowing effect allows the operator to observe structures present behind the directly visualized structure, making it more advantageous than the recent advanced rendering modes, such as three-/fourdimensional ultrasound and HDlive. The contralateral side of the same structure and contralateral limbs can also be displayed. In this article, we highlight this rendering mode, focusing on its merits for the visualization of normal fetal structures as well as some congenital anomalies. How to cite this article AboEllail MAM, Kanenishi K, Marumo G, Masaoka H, Ejiri A, Hata T. Fetal HDlive Silhouette Mode in Clinical Practice. Donald School J Ultrasound Obstet Gynecol 2015;9(4):413-419.

HDliveFlow with HDlive Silhouette Mode in Antenatal Diagnosis of Bilobed Placenta

ABSTRACT We present a case of bilobed placenta diagnosed by HDliveFlow with the HDlive silhouette mode early in the 2nd trimester of pregnancy. A 29-year-old Japanese pregnant woman, gravida 4, para 1, was referred to our hospital based on the patient's wish at 23 weeks and 3 days of gestation. Two-dimensional (2D) sonography showed a single live fetus with biometry consistent with the gestational age. Moreover, two separated parts of the placenta were noted at the anterior and posterior uterine walls. HDliveFlow with the HDlive silhouette mode clearly depicted two lobes of the placenta (near equal size), and the main umbilical cord attached to the periphery of the anterior part of the placenta. One large connecting vessel between these two placental parts was also clearly identified. Bilobed placenta was strongly suggested. After birth, the gross specimen of the placenta confirmed the diagnosis. HDliveFlow with the HDlive silhouette mode may be an adjunctive tool to 2D sonography to diagnose abnormalities of the placenta in utero. How to cite this article Yang P-Y, Kanenishi K, Ishibashi M, Mori N, Hata T. HDliveFlow with HDlive Silhouette Mode in Antenatal Diagnosis of Bilobed Placenta. Donald School J Ultrasound Obstet Gynecol 2016;10(4):415-417.

HDlive Flow with HDlive Silhouette Mode for Diagnosis of Fetal Diaphragmatic Eventration

HDlive Flow with HDlive Silhouette Mode for Diagnosis of Fetal Diaphragmatic Eventration