The use of inversion mode and 3D manual segmentation in volume measurement of fetal fluid‐filled structures: comparison with Virtual Organ Computer‐aided AnaLysis (VOCAL™)

Objective Volume measurements by three‐dimensional (3D) ultrasonography are considered more accurate than those performed by two‐dimensional (2D) ultrasonography. The purpose of this study was to compare the agreement of three techniques, as well as the inter‐ and intraobserver agreements for volume...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2008-02, Vol.31 (2), p.177-186
Main Authors: Kusanovic, J. P., Nien, J. K., Gonçalves, L. F., Espinoza, J., Lee, W., Balasubramaniam, M., Soto, E., Erez, O., Romero, R.
Format: Article
Language:English
Subjects:
3DUS
Biological and medical sciences
Computer Simulation
Female
fetal bladder
fetal stomach
Gynecology. Andrology. Obstetrics
Humans
Image Processing, Computer-Assisted - instrumentation
Imaging, Three-Dimensional - instrumentation
Imaging, Three-Dimensional - methods
Imaging, Three-Dimensional - standards
Medical sciences
Observer Variation
Organ Size
Pregnancy
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Reproducibility of Results
Sensitivity and Specificity
Stomach - diagnostic imaging
Stomach - embryology
three‐dimensional ultrasonography
Ultrasonography, Prenatal - instrumentation
Ultrasonography, Prenatal - methods
Ultrasonography, Prenatal - standards
Urinary Bladder - diagnostic imaging
Urinary Bladder - embryology
volume measurements
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Summary:Objective Volume measurements by three‐dimensional (3D) ultrasonography are considered more accurate than those performed by two‐dimensional (2D) ultrasonography. The purpose of this study was to compare the agreement of three techniques, as well as the inter‐ and intraobserver agreements for volume measurements of fetal fluid‐filled structures. Methods Fifty 3D volume datasets of fetal stomachs and bladders were explored. Volume measurements were performed independently by two observers using: (1) Virtual Organ Computer‐aided AnaLysis (VOCAL™); (2) inversion mode; and (3) ‘manual segmentation’. Reliability was evaluated using intraclass correlation coefficient (ICC), and Bland–Altman plots were generated to examine bias and agreement. The time required to complete the measurements was compared using Student's t‐test or the Wilcoxon Signed Rank Test, and P‐values < 0.025 or < 0.05 were considered statistically significant. Results All volume datasets could be measured using the three techniques. A high degree of reliability was observed between: (1) VOCAL and inversion mode (ICC, 0.995; 95% CI, 0.992–0.997); (2) VOCAL and manual segmentation (ICC, 0.997; 95% CI, 0.995–0.998); and (3) inversion mode and manual segmentation (ICC, 0.995; 95% CI, 0.992–0.997). There was good agreement between VOCAL and inversion mode (mean, − 2.4%; 95% limits of agreement, − 20.1 to 15.3%), VOCAL and manual segmentation (mean, − 8.3%; 95% limits of agreement, − 28.8 to 12.2%) as well as between inversion mode and manual segmentation (mean, 5.9%, 95% limits of agreement: − 14.3 to 26%). Manual segmentation and inversion mode measurements were obtained significantly faster than those by VOCAL. Conclusions Volume measurements of fetal fluid‐filled structures of relatively regular shape with inversion mode and manual segmentation are feasible. Both techniques have good agreement with VOCAL and are significantly faster than VOCAL. Inversion mode is a reliable method for volume calculations of fluid‐filled organs, whereas manual segmentation can be used when volume measurements by VOCAL or inversion mode are technically difficult to obtain, such as solid structures with poorly defined borders as the volume dataset is rotated, like the uterine cervix. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.5242