Abstract
Objectives: 3D-Ultrasound reconstruction, routinely available since 1994, has brought new technical capabilities such as virtual sonography that can be tele-consulted. Our experience is summarized in the present paper.
Methods: During one year, 73 3D-US volumetric images coming from 34 patients were acquired and 68 were consulted at distance. Acquisitions were carried out through an existing 2D device adding a magnetic tracking system on the US-probe. Probe positioning and video output was introduced into a PC running software that allows the generation of 2D-orthogonal and 3D volume images, as well as tele-consultation. Several image analysis techniques for 3D-reconstruction were evaluated.
Results: Final volumes were small (1.5 Mb) and required about 4±2 min to be transmitted over one ISDN channel (64 Kbs). Good correlation (k=0.7) was found between local and distant diagnoses. In 30%, images were considered of low quality and in 29% of good quality; diagnosis could be done with confidence in all except 7 cases. Virtual sonography, by means of oblique cuts in all space directions, improved distant diagnostic confidence. Limitations were linked to incomplete sampling due to the short acquisition time periods (26 s) and difficulties on hand-free probe movement. 3D reconstructions were time consuming (20 min to 4 h) and of limited indication.
Conclusions: 3D reconstruction could reduce multiple explorations due to image constrains such as suboptimal fetal positioning, among others. Virtual sonography was important to reach confidence on distant diagnosis; it was also considered a tool for off-line local review of non-trained sonographer acquisitions.
References
1 Arbeille P, G Poisson, J Ayoub, P Vieyres, M Chevillot, Ph Hervé, M Porcher, JL Boulay: Echographic examination in isolated sites controlled from an expert center using a 2D Echograph guided by a robotic arm. Ultrasound Med Biol29 (2003) 993Search in Google Scholar
2 Beard DV, BM Hemminger, B Keefe, C Mittelstaedt, ED Pisano, JK Lee: Real-time radiologist review of remote ultrasound using low-cost video and voice. Inv Radiology28 (1993) 732Search in Google Scholar
3 Bonilla-Musoles F, F Raga, NG Osborne: Three-dimensional ultrasound evaluation of ovarian masses. Gynecol Oncol59 (1995) 129Search in Google Scholar
4 Campari R, O Botinelli: The latest in ultrasound: three-dimensional imaging. Part II. Europ J Radiol27(supp2) (1998) S18310.1016/S0720-048X(98)00077-1Search in Google Scholar
5 Ewigman BG, JP Crane, FD Frigoletto, ML Lefevre, RP Bain, D McNellis et al.: A randomized trial of prenatal ultrasound screening in a low risk population: impact on perinatal outcome. N Engl J Med329 (1993) 821Search in Google Scholar
6 Ferrer-Roca O, M Sosa-Iudicissa (eds): Handbook of Telemedicine. Amsterdam: IOS-Press. 1998Search in Google Scholar
7 Ferrer Roca O, J Vilarchao, JM Troyano, M Clavijo: Volumen compression issues Virtual Sonography in Internet. (2000), 2–16. http://www.teide.net/catai/bibliog2.htm; www.mdf.be/mednet2000/program/op03.htmlSearch in Google Scholar
8 Ferrer Roca O, J Vilarchao-Cavia, JM Troyano Luque, M Clavijo: Virtual Sonography through the Internet: Volume Compression Issue. J Med Internet Res3 (2001) E 21. http://www.jmir.org/2001/2/e21/19 September 2005Search in Google Scholar
9 Fisk N, S Bower, W Sepulveda, P Garner, K Cameron, M Matthews, D Ridley, K Drysdale, R Wootton: Fetal telemedicine: interactive transfer of realtime ultrasound and video via ISDN for remote consultation. J Telemed Telecare1 (1995) 38Search in Google Scholar
10 Kurjak A, S Kupesic, T Anic, D Kosuta: Three-dimensional ultrasound and power doppler improve the diagnosis of ovarian lesions. Gynecologic Oncol76 (2000) 28Search in Google Scholar
11 Landwehr JB, I Zador, HM Wolfe, MP Dombrowski, MC Treadwell: Telemedicine and fetal ultrasonogrphy: assessment of technical performance and clinical feasibility. Am J Obstet Gynecol177 (1997) 846Search in Google Scholar
12 Macedonia CR., RJ Littlefield, J Coleman, RM Satava, T Cramer, G Mogel, G Eglinton: Three-dimensional ultrasonographic telepresence. J Telemed Telecare4 (1998) 224Search in Google Scholar
13 Malone FD, J Nares, A Athanassiou, SD Craigo, L Simpson, S Garmel, M D′Alton: Validation of fetal telemedicine as a new obstetric imaging technology. Am J Obstet Gynecol177 (1997) 626Search in Google Scholar
14 Nelson TR, DH Pretorius, AS Toaff, MS Sklansky, NE Budorick: Virtual Patient Examination using Three-Dimentional Ultrasound Data acquired at Remote Locations. J Ultrasound Med 18 (suppl) (1999), (abstract from the 43rd Annual Convention; S. Antonio, March 14–17, 1999)Search in Google Scholar
15 OTELO 2004. Mobile Tele-echography system using ultra-lights robots. http://www.bourges.univ-orleans.fr/otelo/project-presentation.htm 19 September 2005Search in Google Scholar
16 Platt LD, T Santulli, DE Carlson, N Greene, CA Walla: Three-dimensional ultrasonogrphy in obstetrics and gynecology: preliminary experience. Am J Obstet Gynecol178 (1998) 1199Search in Google Scholar
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