Three-dimensional Ultrasound Technique Research Articles

Periconceptional maternal and paternal alcohol consumption and embryonic and fetal development: the Rotterdam periconception cohort

Research QuestionWhat is the impact of maternal and paternal alcohol consumption in the periconception period on embryonic and foetal development assessed using three-dimensional ultrasound and VR techniques? DesignThis is a prospective observational study embedded in the Rotterdam Periconception Cohort (Predict study). Participating women received longitudinal 3D transvaginal ultrasound examinations from week 7 up to week 12 of gestation to measure crown-rump length (CRL) and embryonic volume (EV). Mid-pregnancy foetal size parameters and birthweight were retrieved from medical files. Participants filled out a periconception exposure questionnaire and a validated food frequency questionnaire. Linear mixed models were used to analyse the association between parental alcohol consumption, and embryonic and foetal developmental parameters. Results1141 female and 987 male participants were included in our analyses. Maternal moderate alcohol consumption in the periconception period resulted in a smaller head circumference (β=-1.85, SE=0.84, P=0.03), abdominal circumference (β=-2.65, SE=0.93, P=0.004), femur length (β=-0.56, SE=0.22, P=0.01), and estimated foetal weight (β=-9.36, SE=4.35, P=0.03) at 20 weeks of gestation. Paternal alcohol consumption showed significant positive associations, mainly with foetal size parameters (AC: β=0.033, SE=0.01, P=0.008; EFW: β=0.131, SE:0.06, P=0.03). ConclusionsModerate maternal alcohol consumption is negatively associated with foetal growth parameters. Moreover, alcohol is proven a strong teratogen and the consumption before and during pregnancy should be discouraged in both women and men since it affects both several parameters of embryonic and foetal development.

Application of three-dimensional ultrasound technique in repairing dorsal foot wounds with medial sural artery perforator flaps

To investigate the accuracy of positioning perforator of medial sural artery with three-dimensional ultrasound technique guided by a wide band linear matrix array volume transducer probe before operation, and the effectiveness of the flap design based on this in repairing the dorsal foot wounds. Between January 2019 and December 2022, 30 patients with skin and soft tissue defects of the dorsal foot were treated. There were 19 males and 11 females, with an average age of 43.9 years (range, 22-63 years). There were 12 cases of traffic accident injury, 15 cases of heavy crushing injury, and 3 cases of machine injury. The time from injury to hospitalization was 1-8 hours (mean, 3.5 hours). The wounds in size of 5 cm×3 cm to 17 cm×5 cm were thorough debrided and covered with vacuum sealing drainage dressing. Then the wounds were repaired with the medial sural artery perforator flaps after no obvious infection observed. To obtain the complete three-dimensional image, the number and position of the medial sural artery perforator branches and the position of the main blood vessels in the muscle were detected and recorded by wide band linear matrix array volume transducer probe before operation. Suitable perforating branches were selected to design the flap and guide the flap incision on this basis. The size of the perforating flap ranged from 6 cm×4 cm to 18 cm×6 cm. The sensitivity and positive predictive value were calculated by comparing preoperative exploration with intraoperative observation of perforating branches, so as to evaluate the positioning accuracy of three-dimensional ultrasound technique. The donor sites were sutured directly in 25 cases and repaired with free skin grafting in 5 cases. The 60 perforating branches of medial sural artery were found before operation and 58 during operation in 30 patients. Among them, pre- and intra-operative perforations were consistent with 56. The sensitivity was 93.3% and positive predictive value was 96.6%. The intramuscular position and route of the main blood vessels were basically consistent with the pre- and intra-operative observation. All flaps survived and wounds healed by first intention. All incisions at the donor sites healed by first intention, and all skin grafts survived. All patients were follow up 9-24 months (mean, 14.7 months). The appearance, color, and texture of the flaps were good, and no obvious effect on wearing shoes and walking. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind score ranged from 80 to 92, with an average of 87.5. The patient satisfaction was excellent in 29 cases and good in 1 case. The three-dimensional ultrasound technique guided by the wide band linear matrix array volume transducer probe can accurately locate the perforating branch of the medial sural artery, and the three-dimensional imaging is more intuitive, which can be used to guide the design and incision of the medial sural artery perforator flap.

Anatomical Prior and Inter-slice Consistency for Semi-supervised Vertebral Structure Detection in 3D Ultrasound Volume.

Three-dimensional (3D) ultrasound imaging technique has been applied for scoliosis assessment, but the current assessment method only uses coronal projection images and cannot illustrate the 3D deformity and vertebra rotation. The vertebra detection is essential to reveal 3D spine information, but the detection task is challenging due to complex data and limited annotations. We propose VertMatch to detect vertebral structures in 3D ultrasound volume containing a detector and classifier. The detector network finds the potential positions of structures on transverse slice globally, and then the local patches are cropped based on detected positions. The classifier is used to distinguish whether the patches contain real vertebral structures and screen the predicted positions from the detector. VertMatch utilizes unlabeled data in a semi-supervised manner, and we develop two novel techniques for semi-supervised learning: (1) anatomical prior is used to acquire high-quality pseudo labels; (2) inter-slice consistency is used to utilize more unlabeled data by inputting multiple adjacent slices. Experimental results demonstrate that VertMatch can detect vertebra accurately in ultrasound volume and outperforms state-of-the-art methods. Moreover, VertMatch is also validated in automatic spinous process angle measurement on forty subjects with scoliosis, and the results illustrate that it can be a promising approach for the 3D assessment of scoliosis.

Development of Automatic Assessment Framework for Spine Deformity Using Freehand 3-D Ultrasound Imaging System.

A 3-D ultrasound (US) imaging technique has been studied to facilitate the diagnosis of spinal deformity without radiation. The objective of this article is to propose an assessment framework to automatically estimate spinal deformity in US spine images. The proposed framework comprises four major components, a US spine image generator, a novel transformer-based lightweight spine detector network, an angle evaluator, and a 3-D modeler. The principal component analysis (PCA) and discriminative scale space tracking (DSST) method are first adopted to generate the US spine images. The proposed detector is equipped with a redundancy queries removal (RQR) module and a regularization item to realize accurate and unique detection of spine images. Two clinical datasets, a total of 273 images from adolescents with idiopathic scoliosis, are used for the investigation of the proposed framework. The curvature is estimated by the angle evaluator, and the 3-D mesh model is established by the parametric modeling technique. The accuracy rate (AR) of the proposed detector can be achieved at 99.5%, with a minimal redundancy rate (RR) of 1.5%. The correlations between automatic curve measurements on US spine images from two datasets and manual measurements on radiographs are 0.91 and 0.88, respectively. The mean absolute difference (MAD) and standard deviation (SD) are 2.72° ± 2.14° and 2.91° ± 2.36° , respectively. The results demonstrate the effectiveness of the proposed framework to advance the application of the 3-D US imaging technique in clinical practice for scoliosis mass screening and monitoring.

3D Ultrasound and MRI in Assessing Resection Margins during Tongue Cancer Surgery: A Research Protocol for a Clinical Diagnostic Accuracy Study.

Surgery is the primary treatment for tongue cancer. The goal is a complete resection of the tumor with an adequate margin of healthy tissue around the tumor.Inadequate margins lead to a high risk of local cancer recurrence and the need for adjuvant therapies. Ex vivo imaging of the resected surgical specimen has been suggested for margin assessment and improved surgical results. Therefore, we have developed a novel three-dimensional (3D) ultrasound imaging technique to improve the assessment of resection margins during surgery. In this research protocol, we describe a study comparing the accuracy of 3D ultrasound, magnetic resonance imaging (MRI), and clinical examination of the surgical specimen to assess the resection margins during cancer surgery. Tumor segmentation and margin measurement will be performed using 3D ultrasound and MRI of the ex vivo specimen. We will determine the accuracy of each method by comparing the margin measurements and the proportion of correctly classified margins (positive, close, and free) obtained by each technique with respect to the gold standard histopathology.

Cleft palate in fetuses: feasibility of early diagnosis by Crystal and Realistic Vue rendering 3D ultrasound technology in the first trimester.

This study aimed to evaluate the feasibility of direct visualization of a normal fetal palate and detect cleft palate in the first trimester with a novel three-dimensional ultrasound (3D US) technique, Crystal and Realistic Vue (CRV) rendering technology. Two-dimensional (2D) images and 3D volumes of healthy and cleft palate fetuses at 11-13+6 weeks were obtained prospectively. 2D ultrasound views included the coronal view of the retronasal triangle and the midsagittal view of the face. 3D-CRV views were analyzed by multiplanar mode display. The pregnancy outcomes of all fetuses were determined during the follow-up period. In our study, 124 fetuses were recruited, including 100 healthy fetuses and 24 cleft palate fetuses. The cleft palate with lip was observed in 23 fetuses (bilateral in 15, unilateral in 6, median in 2), and one cleft palate was only found in the abnormal group. The bilateral (n = 12) and median (n = 2) cleft palates with lips and the cleft palate alone (n = 1) were associated with other anatomical or chromosomal abnormalities, and one unilateral cleft palate with cleft lip had concomitant NT thickening. In the cleft palate fetus group, 16 fetuses suffered intrauterine death, which was associated with other structural or chromosomal abnormalities in 14 fetuses, seven cases were terminated after consultation, and one was delivered at term. The coronal view of the retronasal triangle and the midsagittal view was easily obtained in all fetuses. 3D-CRV images of palatal parts were clearly obtained in all cases. Unilateral, bilateral, and median cleft palates with cleft lips were visually demonstrated and classified by the 3D-CRV technique. It is feasible to identify the palate by 3D-CRV in the first trimester in both healthy and cleft palate fetuses. Together with 2D ultrasonography as a complementary diagnostic tool, 3D-CRV is helpful in classifying the cleft palate with a reasonable degree of certainty.

Accuracy of automated three-dimensional ultrasound imaging technique for fetal head biometry.

To evaluate the accuracy of an automated three-dimensional (3D) ultrasound technique for fetal intracranial measurements compared with manual acquisition. This was a prospective observational study of patients presenting for routine anatomical survey between 18 + 0 and 22 + 6 weeks' gestation. After providing informed consent, each patient underwent two consecutive ultrasound examinations of the fetal head, one by a sonographer and one by a physician. Each operator obtained manual measurements of the biparietal diameter (BPD), head circumference (HC), transcerebellar diameter (TCD), cisterna magna (CM) and posterior horn of the lateral ventricle (Vp), followed by automated measurements of these structures using an artificial intelligence-based tool, SonoCNS® Fetal Brain. Both operators repeated the automated approach until all five measurements were obtained in a single sweep, up to a maximum of three attempts. The accuracy of automated measurements was compared with that of manual measurements using intraclass correlation coefficients (ICC) by operator type, accounting for patient and ultrasound characteristics. One hundred and forty-three women were enrolled in the study. Median body mass index was 24.0 kg/m2 (interquartile range (IQR), 22.5-26.8 kg/m2 ) and median subcutaneous thickness was 1.6 cm (IQR, 1.3-2.0 cm). Fifteen (10%) patients had at least one prior Cesarean delivery, 17 (12%) had other abdominal surgery and 78 (55%) had an anterior placenta. Successful acquisition of the automated measurements was achieved on the first, second and third attempts in 70%, 22% and 3% of patients, respectively, by sonographers and in 76%, 16% and 3% of cases, respectively, by physicians. The automated algorithm was not able to identify and measure all five structures correctly in six (4%) and seven (5%) patients scanned by the sonographers and physicians, respectively. The ICCs reflected good reliability (0.80-0.88) of the automated compared with the manual approach for BPD and HC and poor to moderate reliability (0.23-0.50) for TCD, CM and Vp. Fetal lie, head position, placental location, maternal subcutaneous thickness and prior Cesarean section were not associated with the success or accuracy of the automated technique. Automated 3D ultrasound imaging of the fetal head using SonoCNS reliably identified and measured BPD and HC but was less consistent in accurately identifying and measuring TCD, CM and Vp. While these results are encouraging, further optimization of the automated technology is necessary prior to incorporation of the technique into routine sonographic protocols. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Reference range of fetal thorax using two-dimensional and three-dimensional ultrasound VOCAL technique and application in fetal thoracic malformations

BackgroundTo establish the normal reference range of fetal thorax by two-dimensional (2D) and three-dimensional (3D) ultrasound VOCAL technique and evaluate the application in diagnosing fetal thoracic malformations.MethodsA prospective cross-sectional study was undertaken involving 1077 women who have a normal singleton pregnancy at 13–40 weeks gestational age (GA). 2D ultrasound and 3D ultrasound VOCAL technique were utilized to assess fetal thoracic transverse diameter, thoracic anteroposterior diameter, thoracic circumference, thoracic area, lung volume, thoracic volume and lung-to-thoracic volume ratio. The nomograms of 2D and 3D fetal thoracic measurements were created to GA. 50 cases were randomly selected to calculate intra- and inter-observer reliability and agreement. In addition, the case groups including congenital skeletal dysplasia (SD) (15), congenital diaphragmatic hernia (CDH) (30), pulmonary sequestration (PS) (25) and congenital cystic adenomatoid malformation (CCAM) (36) were assessed by the nomograms and followed up subsequently.ResultsBoth 2D and 3D fetal thoracic parameters increased with GA using a quadratic regression equation. The intra- and inter-observer reliability and agreement of each thoracic parameter were excellent. 2D fetal thoracic parameters could initially evaluate the fetal thoracic development and diagnose the skeletal thoracic deformity, and lung volume, thoracic volume and lung-to-thorax volume ratio were practical to diagnose and differentiate CDH, PS and CCAM.ConclusionWe have established the normal fetal thoracic reference range at 13–40 weeks, which has a high value in diagnosing congenital thoracic malformations.

Three-Dimensional Inflation Response of Porcine Optic Nerve Head Using High-Frequency Ultrasound Elastography.

Characterization of the biomechanical behavior of the optic nerve head (ONH) in response to intraocular pressure (IOP) elevation is important for understanding glaucoma susceptibility. In this study, we aimed to develop and validate a three-dimensional (3D) ultrasound elastographic technique to obtain mapping and visualization of the 3D distributive displacements and strains of the ONH and surrounding peripapillary tissue (PPT) during whole globe inflation from 15 to 30 mmHg. 3D scans of the posterior eye around the ONH were acquired through full tissue thickness with a high-frequency ultrasound system (50 MHz). A 3D cross-correlation-based speckle-tracking algorithm was used to compute tissue displacements at ∼30,000 kernels distributed within the region of interest (ROI), and the components of the strain tensors were calculated at each kernel by using least square estimation of the displacement gradients. The accuracy of displacement calculation was evaluated using simulated rigid-body translation on ultrasound radiofrequency (RF) data obtained from a porcine posterior eye. The accuracy of strain calculation was evaluated using finite element (FE) models. Three porcine eyes were tested showing that ONH deformation was heterogeneous with localized high strains. Substantial radial (i.e., through-thickness) compression was observed in the anterior ONH and out-of-plane (i.e., perpendicular to the surface of the shell) shear was shown to concentrate in the vicinity of ONH/PPT border. These preliminary results demonstrated the feasibility of this technique to achieve comprehensive 3D evaluation of the mechanical responses of the posterior eye, which may provide mechanistic insights into the regional susceptibility in glaucoma.

1032: Accuracy of three-dimensional automated ultrasound imaging of the fetal brain

To evaluate the accuracy of SonoCNS, an automated three-dimensional (3D) ultrasound (US) technique, compared with manual acquisition of five fetal intracranial measurements. A prospective observational study was performed on patients at their anatomical survey between 18’0-22’6 weeks. After informed consent, each patient received an US of the fetal head by a sonographer and a physician (MD) who each obtained manual measurements of the biparietal diameter (BPD), head circumference (HC), transcerebellar diameter (Cer), cisterna magna (CM) and posterior horn of the lateral ventricle (Vp), followed by measurements using SonoCNS. The 3D acquisition was obtained at the transthalamic plane, employing computer-aided recognition, followed by automated alignment and measurements. Both providers performed SonoCNS until all five measurements were obtained in a single sweep, or a maximum of three attempts. The accuracy of SonoCNS was compared to manual measurements using intraclass coefficients (ICC) by provider type, accounting for patient and US characteristics. 143 women were recruited for the study. Median BMI was 24.0 kg/m2 (IQR 22.5-26.8) and median suprapubic subcutaneous thickness (ST) was 1.6cm (IQR 1.3-2.0). Fifteen patients (11%) had at least one prior cesarean section, 17 (11%) had other abdominal surgery, and 78 (55%) had an anterior placenta. Successful acquisition of SonoCNS was achieved in first, second, or third attempts in 70%, 22% and 4% by sonographers and 76%, 16% and 4% by MD. SonoCNS failed in 6 (4%) and 7 (5%) of scans by the sonographers and MD, respectively. The ICC among both providers was high for BPD and HC and lower for Cer, CM and Vp. (Figure 1) Fetal lie, head position, placental location, ST and prior surgical history were not associated with the accuracy of SonoCNS. (Table 1) Automated 3D US imaging of the fetal brain reliably identify and measure BPD and HC, but were less consistent in accurately identifying the Cer, CM or Vp. Further optimization of the automated technology is necessary prior to incorporation into routine US.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Clinical value of three-dimensional ultrasound VOCAL in evaluation of gastric emptying function in children with functional dyspepsia

Objective To evaluate the clinical value of three-dimensional ultrasound VOCAL technique in evaluating gastric emptying function in children with functional dyspepsia (FD). Methods Seventy-one children with FD who were treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2018 to June 2018 were enrolled as the study subjects (observation group), and 71 normal children without FD were selected as controls (control group). The gastric emptying, antral pyloric systolic contraction frequency and distal gastric contraction movement in different time groups were analyzed, and GET1/2 and 2h gastric residual situation before and after treatment in the observation group were compared. Results The GET1/2 of the observation group was (60.2±12.69)min, and the gastric emptying rate of the observation group was (61.9±12.2)min and (72.0±12.3)min at 90min and 120min, which were significantly better than those of the control group, and the differences were statistically significant (t=19.092, 15.092, 14.882, P=0.016, 0.024, 0.033). The frequency of antral pyloric systolic contraction, gastric antrum contraction frequency and gastric antrum contraction amplitude were (1.1±0.7)times/min, (2.9±0.8)times/min, (1.0±0.6)cm, respectively.Compared with the control group, the differences were statistically significant (t=16.092, 21.224, 8.092, all P<0.05). In the observation group of 71 children: GET1/2 before treatment and after treatment were (68.1±11.8)min, (54.2±9.8)min, respectively.The gastric residual at 2h after treatment was (31.2±8.0)%, (22.1±7.0)%, respectively.The GET1/2 and 2h gastric residual rate of the children were significantly lower than before treatment, and the differences were statistically significant (t=18.983, 21.004, all P<0.05). Conclusion Three-dimensional ultrasound VOCAL technology can be used as an evaluation standard for FD in children. Key words: Dyspepsia; Ultrasonography; Three-dimensional ultrasound technology; Gastric emptying

Evaluation of three-dimensional ultrasound measurement techniques used to assesses myometrial invasion in endometrial cancer

Evaluation of three-dimensional ultrasound measurement techniques used to assesses myometrial invasion in endometrial cancer

Pre-, intra-, and postoperative management of Robert's uterus

To demonstrate a minimally invasive approach and management in three different types of Robert's uterus. Video presentation of surgical and ultrasound techniques. University hospital and two private centers. Patients with three types of Robert's uterus; a rare form of septate uterus consisting of non-communicating hemicavity, a contralateral unicornuate uterine cavity in a single uterine body with normal fundus: with large hematometra in the blind hemi-cavity and acute pelvic pain; with an inactive blind hemi-cavity without hematometra and recurrent miscarriages; and with small hematometra in the blind hemi-cavity. Three-dimensional ultrasound with saline infusion sonohysterography and automatic volume calculation software (SonoHySteroAVC) were used for differential diagnosis and surgical planning. Transrectally guided hysteroscopic metroplasty, a incision of myometrium between two parts of cavities by resectoscope and Collin's electrode, were performed and recorded. Sequentional balloon anti-adhesion therapy and three-dimensional ultrasound with saline infusion sonohysterography with SonoHysteroAVC were used in post-operative management. Pre-, intra- and postoperative findings regarding uterine morphology, feasibility of surgery and anatomical and clinical outcomes. A successful unification of non-communicating and communicating uterine cavity parts during surgery, better shape and several times higher volume of uterine cavity, and total elimination of pain associated with obstruction after healing period were recorded. Three-dimensional ultrasound techniques seem to be the best tool for complex pre- and postoperative management of Robert's uterus. Minimally invasive ultrasound-guided hysteroscopic metroplasty should be considered as the first choice of treatment because of the potential for normalization of uterine morphology and function.

Three-dimensional Ultrasound Volume Measurements in an Aortic Aneurysm Model

Measuring the aneurysm sac’s size is vital in postoperative surveillance following endovascular treatment of aortic aneurysms. A three-dimensional ultrasound technique may enable accurate volume measurements. However, there is no validation of any commercially available electro-mechanical 3D ultrasound equipment or of the software used when measuring the volume of the aortic aneurysm sac. This investigation used a phantom model to study a three-dimensional ultrasound technique on aortic aneurysm sac volume measurements. High volume measurement accuracy indicates that this method may be useful for postoperative surveillance following endovascular aortic aneurysm operations. These results must be confirmed in clinical studies.

Agreement between two 3D ultrasound techniques for the assessment of the subpubic arch angle

Objectives: To assess the reliability of a new three-dimensional (3D) ultrasound technique for the measurement of the subpubic arch angle (SPA) and the agreement between two contrast-enhancing 3D ultrasound techniques.Methods: We acquired two static 3D transperineal volumes from 72 nulliparous women using two ultrasound machines equipped with two different 3D contrast enhancement and linear reconstruction softwares: 1. Oblique View Extended Imaging with HD-Volume Imaging (OVIX-HDVI™), Samsung; 2. Omniview with Volume Contrast Imaging (Omniview-VCI™), GE Healthcare. An operator measured SPA once by OVIX-HDVI, and twice by Omniview-VCI, while another operator measured SPA once by Omniview-VCI. We evaluated intra- and inter-observer reproducibility of Omniview-VCI and intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Bland–Altman method.Results: Omniview-VCI SPA measurements showed excellent intraobserver and interobserver reproducibility (ICC 0.970; 95% C.I. 0.952 to 0.981, 0.932; 95% C.I. 0.893 to 0.957, respectively). Furthermore, Omniview VCI SPA measurements demonstrated excellent agreement with those performed by OVIX-HDVI technique (ICC 0.943; 95 C.I. 0.911 to 0.964). No systematic difference was found in any of the reliability studies.Conclusions: OmniView-VCI is a reliable method for SPA assessment. Both OmniView-VCI and OVIX-HDVI can be used interchangeably for SPA measurement.

Reliability of new three-dimensional ultrasound technique for pelvic hiatal area measurement.

To assess the reproducibility of a new technique for three-/four-dimensional (3D/4D) ultrasound imaging of the pelvic floor: OmniView™ volume contrast imaging (VCI) for measurement of the pelvic hiatal area on maximum contraction and Valsalva maneuver. In addition, we aimed to study the intermethod agreement between the new technique and the 3D/4D render method. We acquired one static 3D and two dynamic 4D transperineal volumes (one obtained during contraction and one during Valsalva maneuver) from 35 nulliparous asymptomatic healthy volunteers and 35 women with symptoms of pelvic floor dysfunction. Each 3D dataset was analyzed using the OmniView-VCI technique to measure the pelvic hiatal area at rest, on maximum contraction and on maximum Valsalva. Analysis was performed twice by the same operator and once by another operator in order to assess intra- and interobserver reproducibility. All measurements were repeated by one operator using the 3D/4D render method to evaluate the intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficients (ICC) and the Bland-Altman method. Measurement of hiatal area using the OmniView-VCI technique showed excellent intraobserver and interobserver reproducibility in both asymptomatic and symptomatic women at rest, on contraction and on Valsalva maneuver. In addition, excellent agreement was demonstrated between OmniView-VCI and 3D/4D render in both groups (ICCs on Valsalva in asymptomatic and symptomatic women were 0.894 and 0.975, respectively). No systematic difference was noted in any of the reliability studies performed. OmniView-VCI is a reliable method for pelvic hiatal area measurement. Both rendering mode and OmniView-VCI can be used interchangeably for assessing pelvic hiatal area. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Three-Dimensional Imaging Using Contrast-Enhanced and Three-Dimensional Ultrasound Techniques in the Ablative Zone Treated with a Multipolar Radiofrequency Ablation System for Hepatocellular Carcinoma

Objectives: The aim of this study was to generate three-dimensional (3D) images of the ablative zone in patients with hepatocellular carcinoma (HCC) treated with multipolar radiofrequency ablation (RFA) using contrast-enhanced ultrasound (CEUS) and 3DUS and to investigate the shape of the ablative zone among several patterns after insertion of two or three electrodes. Methods: This study included 16 patients and 20 HCCs treated with a multipolar RFA system. All patients underwent CEUS within 14 days after multipolar RFA therapy. The 3D scanning functionality of the LOGIQ E9 US imaging system (GE Healthcare, Milwaukee, Wis., USA), which acquires volume data using a manually controlled sweep on perfusion defects of CEUS, was used in this study to acquire CEUS/3DUS data. The ablative-area shapes resulting from three insertion patterns were investigated, using two electrodes (T20-T20 and T30-T30) or three electrodes (T30-T30-T30). Results: The resulting shapes using two electrodes were globule-like (T20-T20) or elliptical (T30-T30). The shape using three electrodes (T30-T30-T30) was almost ellipse-like but slightly irregular. Conclusions: Generating 3D images using CEUS/3DUS techniques is simple and useful for evaluating the shape of the ablative area, and these images provide informational or educational tools for patients and medical staff associated with multipolar RFA procedures.

Monitoring Prostate Tumor Growth in an Orthotopic Mouse Model Using Three-Dimensional Ultrasound Imaging Technique

Prostate cancer (CaP) is the most commonly diagnosed and the second leading cause of death from cancer in males in USA. Prostate orthotopic mouse model has been widely used to study human CaP in preclinical settings. Measurement of changes in tumor size obtained from noninvasive diagnostic images is a standard method for monitoring responses to anticancer modalities. This article reports for the first time the usage of a three-dimensional (3D) ultrasound system equipped with photoacoustic (PA) imaging in monitoring longitudinal prostate tumor growth in a PC-3 orthotopic NODSCID mouse model (n = 8). Two-dimensional and 3D modes of ultrasound show great ability in accurately depicting the size and shape of prostate tumors. PA function on two-dimensional and 3D images showed average oxygen saturation and average hemoglobin concentration of the tumor. Results showed a good fit in representative exponential tumor growth curves (n = 3; r2 = 0.948, 0.955, and 0.953, respectively) and a good correlation of tumor volume measurements performed in vivo with autopsy (n = 8, r = 0.95, P < .001). The application of 3D ultrasound imaging proved to be a useful imaging modality in monitoring tumor growth in an orthotopic mouse model, with advantages such as high contrast, uncomplicated protocols, economical equipment, and nonharmfulness to animals. PA mode also enabled display of blood oxygenation surrounding the tumor and tumor vasculature and angiogenesis, making 3D ultrasound imaging an ideal tool for preclinical cancer research.

Three-dimensional ultrasonography for visualization of muscular anomalies in type VI and VII radial polydactyly.

To describe a technique and its clinical applications of three-dimensional ultrasonography to type VI and VII radial polydactyly for identification of potential muscular anomalies. Ultrasonographic examinations were performed at an out-patient department without sedation or an operative room prior to surgery. The palm was scanned in the transverse direction using a 18-MHz linear transducer under speed regulation at 3 mm/s. Sequential images acquired at 0.2 mm intervals were converted into volume data. After validation of the technique, patients with a radial polydactyly in association with triphalangism (type VII) or with polydactylies of metacarpal duplication (type VI) were included for the examination. Five hands of five patients, one with type VI and four with type VII, were included the study. All the patients were male and the ages at examination ranged from 7 months to 2 years. Of the five patients, four examinations were performed at an out-patient department without sedation and one was under anesthesia just prior to surgery. The muscular abnormalities identified were mal-positions of the thenar muscles in a type VI case and a deficiency of the abductor pollicis brevis muscle in a type VII case with a delta phalanx in the ulnar part. Three-dimensional ultrasound technique could be an aid to plan strategies in radial polydactyly if intrinsic muscular anomalies are suspected to be involved.

A critical review of bi-dimensional and three-dimensional ultrasound techniques to monitor follicle growth: do they help improving IVF outcome?

BackgroundThis review focuses on the possibility of improving the outcome of human IVF by studying the follicles where oocytes grow by ultrasound techniques. A comprehensive analysis of bi-dimensional (2D) and three-dimensional (3D) ultrasound (US) assessment of the follicle size and volume is presented.MethodsPublished reports from the year 1999 to 2014 analyzing the relationship between oocyte competence, IVF outcome and ultrasound assessment of the follicle size and volume have been critically analyzed.ResultsUS assessment of growing follicles has been performed mainly by 2D-US, and while overall very useful, it has been found to be of limited usefulness in predicting oocyte competence, recognize which follicles will release a mature metaphase II oocytes and decide the ideal time to trigger ovulation. In fact, a quite wide follicle size range (16–22 mm) has been reported to be associated with mature oocytes with good competence toward fertilization and embryo development. It has been also shown that smaller follicles sometimes contain mature, fertilizable oocytes. However, embryos derived from smaller follicles have probably a lower implantation potential, while follicles larger than 22 mm often contain post-mature eggs.ConclusionsThe study of follicular size by 2D-US is of limited usefulness in helping in the identification of follicles containing the best oocytes and in choosing the best moment to trigger ovulation. Possibly the value of US in this area will be improved by large prospective studies in which automated 3D-US will be used.