3D Ultrasound in Gynecology and Reproductive Medicine

Abstract

With advances occurring in medicine on a daily basis, it was only a matter of time before essential gynecological investigations, such as ultrasound, were modified. Many clinicians remain unconvinced by its reputed advantages and 3D ultrasound is not without disadvantages. These mainly relate to the cost implications and training requirements. 3D ultrasound imaging is still at a relatively early stage in terms of its role as a day-to-day imaging modality in gynecology and reproductive medicine. 3D imaging has several obvious benefits that relate to an improved spatial orientation and the demonstration of multiplanar views, of which the coronal plane is particularly useful. It offers a more objective and reproducible measurement of volume and vascularity of the region of interest, and an improved assessment of normal and pathological pelvic organs through further postprocessing modalities, including tomographic ultrasound imaging and various rendering modalities. It also has the benefit of offering reduced scanning time, the option of teleconsultation and storage of images for re-evaluation. However, other than its application in the assessment and differentiation of uterine anomalies, there is very little evidence demonstrating that 3D ultrasound results in a clinically relevant benefit or negates the need for further investigation. Future work should ensure that 3D ultrasound is compared with conventional imaging in randomized trials where the observer is blind to the outcome, only after which will we truly be able to evaluate its role in an evidence-based manner.With advances occurring in medicine on a daily basis, it was only a matter of time before essential gynecological investigations, such as ultrasound, were modified. 2D ultrasound has been one of the key modes of investigation for years, but recent developments have seen the introduction of 3D ultrasound. This review focuses on the current role of 3D imaging in the field of gynecology and reproductive medicine, and outlines how our practice may change in the future as a result. However, very few studies have truly compared conventional ultrasound with 3D ultrasound and the following article appraises the current evidence, which is often derived from observational studies.What is 3D ultrasound? Conventional (2D) ultrasound is the most widely available modality at present. 2D ultrasound essentially provides us with 2D images of 3D structures, which appear as real-time crosssectional slices through the organ/structures being examined. The views can, at times, be restricted owing to limited scan planes. By contrast, 3D ultrasound techniques rely upon the production of a composite of multiple 2D scan images. Computing software is then used to fill in the gaps or 'interpolate' between these images to produce a solid volume. The acquired 3D ultrasound volume can then be displayed collectively in a variety of imaging modalities. Several viewing modalities are available to maximize the display of the acquired 3D images. The render mode shows a single image repre...

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