First-Trimester Detection of Surface Abnormalities: A Comparison of 2- and 3-Dimensional Ultrasound and 3-Dimensional Virtual Reality Ultrasound

Abstract

The aim was to determine the diagnostic performance of 3-dimensional virtual reality ultrasound (3D_VR_US) and conventional 2-and 3-dimensional ultrasound (2D/3D_US) for first-trimester detection of structural abnormalities. Forty-eight first trimester cases (gold standard available, 22 normal, 26 abnormal) were evaluated offline using both techniques by 5 experienced, blinded sonographers. In each case, we analyzed whether each organ category was correctly indicated as normal or abnormal and whether the specific diagnosis was correctly made. Sensitivity in terms of normal or abnormal was comparable for both techniques (P ¼ .24). The general sensitivity for specific diagnoses was 62.6% using 3D_VR_US and 52.2% using 2D/3D_US (P ¼ .075). The 3D_VR_US more often correctly diagnosed skeleton/limb malformations (36.7% vs 10%; P ¼ .013). Mean evaluation time in 3D_VR_US was 4:24 minutes and in 2D/3D_US 2:53 minutes (P < .001). General diagnostic performance of 3D_VR_US and 2D/3D_US apparently is comparable. Malformations of skeleton and limbs are more often detected using 3D_VR_US. Evaluation time is longer in 3D_VR_US.

First trimester anomaly scan using virtual reality (VR FETUS study): study protocol for a randomized clinical trial

“…One previous study has shown a high sensitivity for the detection of structural anomalies in the first trimester using 3D VR and a trend towards improved detection rates [ 16 ]. 3D VR may especially improve the detection of surface anomalies in the first trimester [ 20 ]. Timely detection of major congenital malformations will provide women at risk with additional time to perform (genetic) testing as well as more time to consider continuation or termination of pregnancy.…”

“…As mentioned before, the detection rate in a high risk population is estimated at 61%, and in a low risk population at 63% for 2D ultrasonography [ 6 , 8 ]. The detection rate for anomalies of the first trimester 3D VR ultrasound is 62.5% [ 20 ]. For second trimester (18–22 weeks’ gestation) 2D ultrasound the detection rate lies between 44.3 and 74.4% [ 40 – 42 ].…”

“…This system can be used in daily outpatient practice, offering the same functionality at a fraction of the cost [ 17 , 18 ]. Baken et al have compared 2D ultrasound, 3D ultrasound and 3D VR for detection of first trimester fetal anomalies [ 20 ]. This retrospective study showed that the general diagnostic performance between the different methods was comparable (sensitivity 3D: 52.2%, 3D VR 62.6%; specificity 3D: 99.7%, 3D VR 99.6%).…”