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Noguchi H, Iwasa T, Iwase A, Kanasaki H, Kimura F, Kugu K, Saito K, Baba T, Hara T, Matsuzaki T. Cut-off value for anti-Müllerian hormone in the diagnostic criteria for polycystic ovary syndrome in the Japanese population. J Obstet Gynaecol Res 2024; 50:1368-1382. [PMID: 38831323 DOI: 10.1111/jog.15972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 05/05/2024] [Indexed: 06/05/2024]
Abstract
AIM To establish cut-off values for anti-Müllerian hormone (AMH) and antral follicle count (AFC) in the diagnostic criteria for polycystic ovary syndrome (PCOS) applicable to the Japan Society of Obstetrics and Gynecology (JSOG) 2024 criteria and the Rotterdam/International Evidence-Based Guideline for the assessment and management of PCOS (IEBG) 2023 criteria based on a nationwide survey, respectively, taking into account age, assays, and structure of the diagnostic criteria. METHODS Data were collected for 986 PCOS cases and 965 control cases using a national survey in Japan and used to establish cut-off values for AMH and AFC. RESULTS Serum AMH levels were significantly higher in the PCOS group compared to the control group. Serum AMH showed a significant negative correlation with age and significant positive correlation with AFC in both groups. In multiple regression analysis, serum AMH level was independently affected by AFC and total testosterone. AMH cut-off values suitable for the JSOG 2024 criteria and the Rotterdam/IEBG 2023 criteria were separately established for the 20-29 and 30-39 years of age groups, respectively, and for Access, Lumipulse and Elecsys/ECLusys, respectively. AFC cut-off values suitable for the JSOG 2024 criteria and Rotterdam/IEBG 2023 criteria were also established separately. AFC exhibited statistically greater variability than AMH. CONCLUSION The serum AMH level is the biochemical representation of ovarian findings in PCOS and considered objective and highly reliable. Therefore, it could serve as a surrogate for AFC as a marker of polycystic ovarian morphology in diagnostic criteria.
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Affiliation(s)
- Hiroki Noguchi
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Takeshi Iwasa
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Akira Iwase
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Haruhiko Kanasaki
- Obstetrics and Gynecology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Koji Kugu
- Department of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Kazuki Saito
- Department of Perinatal and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Baba
- Department of Obstetrics and Gynecology, Sapporo Medical University, Hokkaido, Japan
| | - Tetsuaki Hara
- Division of Reproductive Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Toshiya Matsuzaki
- Department of Obstetrics and Gynecology, Yoshinogawa Medical Center, Tokushima, Japan
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Kyprianou MA, Dakou K, Lainas GT, Xenariou M, Makris A, Lainas TG. Two-dimensional ultrasound results in underestimation of the ovarian follicle size compared to automated three-dimensional imaging in women undergoing IVF. J Ultrasound 2023:10.1007/s40477-023-00797-1. [PMID: 37351770 DOI: 10.1007/s40477-023-00797-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/04/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Traditionally, for the assessment of follicle growth during IVF, two-dimensional (2D) transvaginal ultrasound (US) is used. In the past few years three-dimensional (3D) US has also been introduced. OBJECTIVES To compare follicular sizes between 2 and 3D ultrasound imaging on the final day of controlled ovarian stimulation. METHODS A prospective observational cohort study including 121 women undergoing controlled ovarian stimulation (COS) between January 2017 and July 2018. All women were assessed by transvaginal 2D and 3D ultrasonography to measure ovarian follicle dimensions on the final day of COS. RESULTS The mean difference in paired comparisons between the 3D and 2D US measurements in 25 women with monofollicular development was + 1.6 ± 2.5 mm for the x-dimension and + 1.7 ± 2.4 mm for the y-dimension; and in the total number of 1197 paired measurements of follicles the mean difference + 2.1 ± 3.3 mm and + 1.8 ± 3.9 mm for the x- and y-dimension respectively. In all cases the paired t-test showed that differences were statistically significant (p < 0.01). Further it was conjectured that the 2D underestimation results from the inherent difficulty to precisely place the US probe simultaneously on the perpendicular maximal of the x and y follicle diameters, leading to measurement errors that, by theory, are normally distributed. Running Monte-Carlo simulations based on these measurement errors it was found that both the mean difference and standard deviation are of the same magnitude as the ones found in real measurements, thus proving the conjecture. CONCLUSIONS The utilisation of 3D US results in different measurements of the follicular dimensions, and volumes, when compared to conventional 2D US. The differences in the x- and y-dimensions may affect the outcome of an IVF cycle as they are used to define the day of triggering final oocyte maturation, which is associated with the yield of mature oocytes and the probability of live birth.
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A comparison of two- and three-dimensional ultrasonographic methods for evaluation of ovarian follicle counts and classification of polycystic ovarian morphology. Fertil Steril 2021; 115:761-770. [PMID: 33618897 DOI: 10.1016/j.fertnstert.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To determine the level of agreement across assessments of follicle number per ovary (FNPO) and classifying of polycystic ovarian morphology (PCOM; FNPO ≥25) with the use of various real-time (RT) and off-line two-dimensional (2D) and three-dimensional (3D) ultrasonographic methods. DESIGN Method comparison study. SETTING University-based clinical research unit. PATIENT(S) Sixteen women with and without PCOM. INTERVENTION Thirty-two ovaries were analyzed with the use of eight ultrasonographic methods: 2D-Grid (reference method), 2D-RT, 2D-RT with Grid, multiplanar view (MPV), MPV-RT, tomographic ultrasound imaging (TUI), TUI-RT, and semiautomated volume calculation (SonoAVC). MAIN OUTCOME MEASURE(S) FNPO, PCOM status, and time to obtain FNPO. Clinical feasibility, defined as the time taken to obtain FNPO, also was evaluated. RESULT(S) 2D-RT overestimated FNPO versus 2D-Grid (3 ± 9 follicles) owing to overcounting in non-PCOM ovaries (6 ± 6 follicles). However, systematic bias was not detected when a grid overlay was incorporated (2D-RT with Grid). SonoAVC underestimated FNPO (-3 ± 5 follicles), particularly in PCOM ovaries (-4.1 ± 5.0 follicles). No bias in FNPO was detected between MPV, TUI, or TUI-RT versus 2D-Grid. 2D-RT significantly misclassified ovaries as PCOM. All methods except MPV took less time to complete FNPO assessments compared with 2D-Grid. CONCLUSION(S) Variability in FNPO across ultrasonographic methods limits their interchangeable use, particularly when a precise metric is needed. 2D-RT may be problematic owing to its propensity to misclassify PCOM. 2D-RT with Grid and MPV-RT could represent clinically feasible alternatives to obtain FNPO and classify PCOM. Efforts to reduce variation in FNPO will clarify the relevance of PCOM in women's health.
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Noor N, Vignarajan CP, Malhotra N, Vanamail P. Three-Dimensional Automated Volume Calculation (Sonography-Based Automated Volume Count) versus Two-Dimensional Manual Ultrasonography for Follicular Tracking and Oocyte Retrieval in Women Undergoing in vitro Fertilization-Embryo Transfer: A Randomized Controlled Trial. J Hum Reprod Sci 2020; 13:296-302. [PMID: 33627979 PMCID: PMC7879837 DOI: 10.4103/jhrs.jhrs_91_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/10/2020] [Accepted: 10/17/2020] [Indexed: 11/05/2022] Open
Abstract
Aim: To compare the oocyte yield using three-dimensional (3D) automated and two-dimensional (2D) ultrasound-based follicle tracking in women undergoing in vitro fertilization-embryo transfer (IVF-ET). Settings and Design: A randomized controlled trial was conducted in the Reproductive Medicine Unit of a teaching medical institute from January 2017 to December 2018. Materials and Methods: A total of 130 patients undergoing IVF-ET were enrolled and randomized into two groups (65 patients in each group). In Group A, follicular tracking during controlled ovarian stimulation (COS) was done using 3D Sonography- based Automated Volume Count (SonoAVC), whereas in Group B, follicular tracking was done by manual ultrasonography (2D USG). The primary outcome measures were the number of oocytes retrieved (the total number and the number of mature oocytes). Secondary outcomes were fertilization rate, cleavage rate, total number of embryos and time taken to perform scans. Other outcome measures were clinical pregnancy rate, miscarriage rate and live birth rate (LBR). Statistical Analysis Used: Chi-square test, Student's t-test, Z-test, Wilcoxon rank-sum test, Bland–Altman's plot. Results: The two groups were comparable with regard to assisted reproductive technology (ART) outcomes. Group B required more time for performing the scan (P < 0.01). Conclusion: Automated SonoAVC ultrasound can be used interchangeably with manual 2D USG for follicle tracking during COS giving comparable ART outcomes with the added advantage of saving time. Our study implies the promising results of applying artificial intelligence in follicular tracking during COS.
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Affiliation(s)
- Nilofar Noor
- Department of Obstetrics and Gynaecology, Reproductive Medicine Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Chithira Pulimoottil Vignarajan
- Department of Obstetrics and Gynaecology, Reproductive Medicine Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Malhotra
- Department of Obstetrics and Gynaecology, Reproductive Medicine Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Perumal Vanamail
- Department of Obstetrics and Gynaecology, Reproductive Medicine Unit, All India Institute of Medical Sciences, New Delhi, India
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Re C, Mignini Renzini M, Rodriguez A, Dal Canto M, Buccheri M, Sacchi S, Bartolucci S, Fadini R, La Marca A. From a circle to a sphere: the ultrasound imaging of ovarian follicle with 2D and 3D technology. Gynecol Endocrinol 2019; 35:184-189. [PMID: 30394144 DOI: 10.1080/09513590.2018.1522297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Ultrasound follicular count (antral follicle count, AFC) is a necessary tool for measuring ovarian reserve, whereby the estimated number of follicles responsive to FSH can predict the number of oocytes retrieved in IVF cycles and may be the basis for individualized ovarian stimulation therapy. Advances in the ultrasound technology have recently lead to the improvement in resolution and quality of the image. Moreover the automatic measurements of follicular diameter by using some specific 3D software seems associated to several advantages when compared to the 2D technique. Examination time is reduced because the ultrasound scan data are stored and can be analyzed in detail at a later time. These data can be reconstructed in any plane, regardless of the original scan plane facilitating the detailed analysis. Another advantage is that this new technique reduces the operator's influence on scan interpretation and objectivity; therefore, interobserver variability is reduced. Using follicular volume obtained with sono AVC as the measure of follicular growth combined with volume-based criteria for the hCG triggering may in the future improve the treatment outcome compared to that achieved with conventional monitoring with follicular diameter. Better knowledge in this area could be helpful to optimize IVF outcome, by refining ovarian stimulation protocols and obtain high quality oocytes.
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Affiliation(s)
- Claudia Re
- a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy
| | - Mario Mignini Renzini
- b Modena and Biogenesi, Reproductive Medicine Centre , Clinica EUGIN , Monza , Italy
| | | | | | | | - Sandro Sacchi
- a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy
| | | | - Rubens Fadini
- b Modena and Biogenesi, Reproductive Medicine Centre , Clinica EUGIN , Monza , Italy
| | - Antonio La Marca
- a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy
- d Clinica EUGIN , Modena , Italy
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Wertheimer A, Nagar R, Oron G, Meizner I, Fisch B, Ben-Haroush A. Fertility Treatment Outcomes After Follicle Tracking With Standard 2-Dimensional Sonography Versus 3-Dimensional Sonography-Based Automated Volume Count: Prospective Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:859-866. [PMID: 28960452 DOI: 10.1002/jum.14421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/27/2017] [Accepted: 07/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The use of sonography-based Automated Volume Count (SonoAVC; GE Healthcare, Kretz, Zipf, Austria) leads to substantially lower intraobserver and interobserver variability with a considerable advantage in time gain for both the physician and patient. It offers the possibility of continuous training and standardization of follicular monitoring. Manual and automated follicular measurements during in vitro fertilization (IVF) are reported to be comparable during gonadotropin-releasing hormone (GnRH) agonist treatment. The aim of our study was to evaluate the effect of follicle tracking with 3-dimensional (3D) SonoAVC on treatment outcomes in GnRH antagonist IVF cycles. METHODS A prospective trial included 54 women undergoing their first to fourth GnRH antagonist IVF cycles. Follicle tracking from the initiation of ovarian stimulation until the day of oocyte retrieval and timing of oocyte retrieval was done either by conventional 2-dimensional (2D) sonography or 3D SonoAVC (open-labeled parallel assignment). In both groups, recombinant human chorionic gonadotropin was injected when there were at least 3 leading follicles measuring 17 mm. The primary outcome was the oocyte maturation rate, and secondary outcomes were the fertilization rate and clinical pregnancy rate. RESULTS The number of retrieved oocytes, number and rate of mature oocytes, fertilization rate, and clinical pregnancy rate were similar for 2D sonography and 3D SonoAVC. On a multivariate regression analysis, the use of 3D sonography was not a significant independent predictor of mature oocytes or clinical pregnancy rates. CONCLUSIONS Follicle tracking with 3D sonographic follicular volume measurements does not achieve better fertility outcomes than standard 2D sonography.
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Affiliation(s)
- Avital Wertheimer
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ran Nagar
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Galia Oron
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Israel Meizner
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Benjamin Fisch
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Avi Ben-Haroush
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
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Froyman W, Van Schoubroeck D, Timmerman D. Automated follicle count using three-dimensional ultrasound in polycystic ovarian morphology. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:147-149. [PMID: 28876497 DOI: 10.1002/uog.18896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 08/17/2017] [Accepted: 08/24/2017] [Indexed: 06/07/2023]
Affiliation(s)
- W Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - D Van Schoubroeck
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
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Peres Fagundes PA, Chapon R, Olsen PR, Schuster AK, Mattia MMC, Cunha-Filho JS. Evaluation of three-dimensional SonoAVC ultrasound for antral follicle count in infertile women: its agreement with conventional two-dimensional ultrasound and serum levels of anti-Müllerian hormone. Reprod Biol Endocrinol 2017; 15:96. [PMID: 29246176 PMCID: PMC5732451 DOI: 10.1186/s12958-017-0314-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/03/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Several studies have reported a correlation between antral follicle count by conventional 2D transvaginal sonography and serum anti-Müllerian hormone levels. However, few studies have investigated the effectiveness of 3D SonoAVC transvaginal ultrasound technology, particularly in infertile women. Therefore, this study aims to evaluate the usefulness of three-dimensional (3D) SonoAVC transvaginal ultrasound technology for antral follicle count and its correlation to conventional two-dimensional (2D) transvaginal ultrasound and serum levels of anti-Müllerian hormone in infertile women. METHODS This cross-sectional study included 42 infertile women with age lower than 40 years that underwent treatment at a private fertility clinic between June and December 2015. Patient data included age, body mass index and cause of infertility. On cycle day 3 the following hormone levels were measured: serum levels of anti-Müllerian hormone, follicle-stimulating hormone, cancer antigen 125, prolactin, thyroid-stimulating hormone and oestradiol; the number of antral follicles was counted as well. The scanning were performed through 2D and 3D technology transvaginal ultrasound. RESULTS Using a Bland-Altman test we demonstrated that both technologies are quite equivalent. However, antral follicle count is higher using 3D ultrasound technology compared to 2D technology (p < 0.001; Wilcoxon test), this finding is mainly remarkable in ovaries with more than 20 antral follicles. Moreover, the mean time required for manual 2D ultrasound and 3D SonoAVC measurements were 275 ± 109 and 103 ± 57 s, respectively (p < 0.001). Serum AMH concentration correlated to the total number of early antral follicles (correlation coefficients = 0.678 and 0.612; p < 0.001 by 2D ultrasound and 3D SonoAVC, respectively; Spearman's correlation test). CONCLUSIONS Antral follicle count is better estimated using 3D ultrasound compared to 2D technology. A great advantage of 3D SonoAVC was less time required for an examination and the visual advantage when it need to count more than 20 follicles. TRIAL REGISTRATION CAAE: 35141114.4.0000.5327 . Registered 10 June 2015.
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Affiliation(s)
- P. A. Peres Fagundes
- INSEMINE, Human Reproductive Center, Avenida Dr. Nilo Peçanha 2825, Porto Alegre, 91330-001 Brazil
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
| | - R. Chapon
- INSEMINE, Human Reproductive Center, Avenida Dr. Nilo Peçanha 2825, Porto Alegre, 91330-001 Brazil
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
| | - P. R. Olsen
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
| | - A. K. Schuster
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
| | - M. M. C. Mattia
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
- 0000 0001 2200 7498grid.8532.cPPGGO, Graduate Program in Health Sciences: Gynecology and Obstetrics, Faculty of Medicine, UFRGS, Rua Ramiro Barcelos, 2400, 2° andar, Porto Alegre, 90035-003 Brazil
| | - J. S. Cunha-Filho
- INSEMINE, Human Reproductive Center, Avenida Dr. Nilo Peçanha 2825, Porto Alegre, 91330-001 Brazil
- 0000 0001 0125 3761grid.414449.8UFRGS, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-903 Brazil
- UFRGS, Universidade Federal do Rio Grande do Sul, Department of Gynecology and Obstetrics, Porto Alegre Clinical Hospital, Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903 Brazil
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Gerris J, Delvigne A, Dhont N, Vandekerckhove F, Madoc B, Buyle M, Neyskens J, Deschepper E, De Bacquer D, Pil L, Annemans L, Verpoest W, De Sutter P. Self-operated endovaginal telemonitoring versus traditional monitoring of ovarian stimulation in assisted reproduction: an RCT. Hum Reprod 2014; 29:1941-8. [DOI: 10.1093/humrep/deu168] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vandekerckhove F, Bracke V, De Sutter P. The Value of Automated Follicle Volume Measurements in IVF/ICSI. Front Surg 2014; 1:18. [PMID: 25593942 PMCID: PMC4286967 DOI: 10.3389/fsurg.2014.00018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/16/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/AIMS The objective of this literature study is to investigate the place of recent software technology sonography-based automated volume count (SonoAVC) for the automatic measurement of follicular volumes in IVF/ICSI. Its advantages and disadvantages and potential future developments are evaluated. METHODS A total of 74 articles were read via a PubMed literature study. The literature study included 53 articles, 32 of which for the systematic review. RESULTS The SonoAVC software shows excellent accuracy. Comparing the technology with the "golden standard" two-dimensional (2D) manual follicle measurements, SonoAVC leads to a significantly lower intra- and inter-observer variability. However, there is no significant difference in clinical outcome (pregnancy rate). We noted a significant advantage in the time gained, both for doctor and patient. By storing the images, the technology offers the possibility of including a quality control and continuous training and further standardization of follicular monitoring can be expected. Ovarian reserve testing by measuring the antral follicle count with SonoAVC is highly reliable. CONCLUSION This overview of previously published literature shows how SonoAVC offers advantages for clinical practice, without losing any accuracy or reliability. Doctors should be motivated to the general use of follicular volumes instead of follicular diameters.
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Affiliation(s)
| | - Victoria Bracke
- Centre for Reproductive Medicine, University Hospital Ghent , Ghent , Belgium
| | - Petra De Sutter
- Centre for Reproductive Medicine, University Hospital Ghent , Ghent , Belgium
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Rodriguez A, Guillén JJ, López MJ, Vassena R, Coll O, Vernaeve V. Learning curves in 3-dimensional sonographic follicle monitoring during controlled ovarian stimulation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:649-655. [PMID: 24658944 DOI: 10.7863/ultra.33.4.649] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Three-dimensional (3D) sonographically based automated volume calculation (SonoAVC; GE Healthcare, Zipf, Austria) is being introduced in folliculometry during ovarian stimulation; however, clear training assessments in this technique are lacking. The learning curve-cumulative summation (LC-CUSUM) test provides a quantitative tool to determine when a trainee has learned a procedure. The aim of this prospective study was to assess 3D SonoAVC LC-CUSUM curves in folliculometry. METHODS Analyses were performed on 98 oocyte donors by capturing the ovarian image in 3D and applying the 3D SonoAVC software during ovarian stimulation cycles. Each patient was scanned by an expert operator and by a trainee. Independent LC-CUSUM tests for 4 follicular diameters tracked the competency of 3 trainees in 3D SonoAVC. RESULTS We found that the numbers of sonographic examinations required by the 3 trainees to identify the correct number of follicles of 10 mm or larger were 38, 32, and 28, respectively; for follicles of 14 mm or larger, they were 29, 28, and 28; for follicles of 18 mm or larger, they were 24, 19, and 27; and for follicles of 21 mm or larger, they were 29, 19, and 24. CONCLUSIONS A variable number of procedures are needed to reach proficiency in 3D SonoAVC, even for trained 2-dimensional sonographers. Assessment of learning curves should be implemented when incorporating 3D SonoAVC in reproduction units.
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Affiliation(s)
| | | | | | - Rita Vassena
- DVM, Clinica Eugin, Travessera de les Corts 322, 08029 Barcelona Spain.
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Pan P, Chen X, Li Y, Zhang Q, Zhao X, Bodombossou-Djobo MMA, Yang D. Comparison of manual and automated measurements of monodominant follicle diameter with different follicle size in infertile patients. PLoS One 2013; 8:e77095. [PMID: 24130840 PMCID: PMC3794997 DOI: 10.1371/journal.pone.0077095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022] Open
Abstract
This study evaluated the consistency of manual and automated measurements of monodominant follicle diameter with different follicle size in infertile patients. Transvaginal two-dimensional (2D) ultrasound and SonoAVC (Sonography-based Automated Volume Calculation) were both performed in 226 infertile patients with monodominant follicle growth. 2D diameters were separately compared with SonoAVC-generated d(V) and m-d values in different follicle category, i.e. >10 to 14 mm, >14 to 18 mm, >18 to 22 mm and >22 mm. There was moderate degree of consistency between 2D diameter and SonoAVC-generated parameters regardless of follicle size. The mean differences were 0.82 mm between 2D diameter and SonoAVC-generated d(V) value, and 0.22 mm between 2D diameter and SonoAVC-generated m-d value, respectively. The discrepancy of manual and automated measurements tended to increase as follicle size increased. Our study suggested that compared with manual measurement, SonoAVC might underestimate follicle size. The absolute size of a follicle affected the consistency of two techniques.
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Affiliation(s)
- Ping Pan
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
- Department of Reproductive Medicine, Guangdong Provincial Family Planning Research Institute, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaoli Chen
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Yu Li
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Qingxue Zhang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaomiao Zhao
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Madafeitom M. A. Bodombossou-Djobo
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
- Fertility Medical Center, Guangzhou Elizabeth Women's Hospital, Guangzhou, Guangdong, People’s Republic of China
| | - Dongzi Yang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
- * E-mail:
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Duin LK, Willekes C, Vossen M, Offermans J, Nijhuis JG. Reproducibility of fetal renal pelvis volume assessed by three-dimensional ultrasonography with two different measurement techniques. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:230-234. [PMID: 23325421 DOI: 10.1002/jcu.22039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/05/2012] [Indexed: 06/01/2023]
Abstract
PURPOSE To evaluate reproducibility of fetal renal pelvis volume as assessed by the Virtual Organ Computer Aided AnaLysis (VOCAL) imaging program and by Automatic Volume Calculation (SonoAVC). In addition, the intra- and interobserver reliability of fetal renal pelvis volume measurements with SonoAVC were established. METHODS In this study, the fetal renal pelvis volume was measured using 3D ultrasonography in 76 kidneys of 66 fetuses with renal pelvis dilatation in the second or third trimester of pregnancy. After volume acquisition by one observer, the reproducibility of volume calculation was assessed using VOCAL imaging program and SonoAVC by two observers. Intra- and interobserver reproducibility was evaluated by calculating intraclass correlation coefficients (ICC), coefficient of variation (CV) and repeatability coefficient (r). Bland-Altman plots were generated to explore agreement. RESULTS A high degree of reproducibility was observed between VOCAL and SonoAVC, ICC of 0.989; 95% CI 0.983-0.993, respectively. Intraobserver reproducibility of volume measurements performed by SonoAVC demonstrated a high degree of reliability with ICC of 0.995 (95% CI 0.993-0.997), CV 6.05% and r of 0.75. The interobserver reproducibility with ICC of 0.995 (95% CI 0.992-0.997), CV 10.14% and r 1.21 was also indicative of good reliability. CONCLUSION Volume measurements of fetal renal pelvis performed by SonoAVC renders reproducible measurements in comparison with the VOCAL imaging program. There is no significant difference between VOCAL imaging program and SonoAVC. The intra- and interobserver reliability of the fetal renal pelvis measurements made by SonoAVC were considered to be very good. SonoAVC, however, needs post processing in the majority of cases but is less time consuming than VOCAL.
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Affiliation(s)
- L K Duin
- Department of Obstetrics and Gynecology of the Maastricht University Medical Centre, 5500 MB Veldhoven, The Netherlands.
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Jokubkiene L, Sladkevicius P, Valentin L. Number of antral follicles, ovarian volume, and vascular indices in asymptomatic women 20 to 39 years old as assessed by 3-dimensional sonography: a prospective cross-sectional study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1635-1649. [PMID: 23011627 DOI: 10.7863/jum.2012.31.10.1635] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Our aim was to elicit data representative of normal findings on 3-dimensional (3D) transvaginal gray-scale and power Doppler sonography of ovaries in women of fertile age. METHODS A total of 303 gynecologically asymptomatic white women 20 to 39 years old with spontaneous regular menstrual cycles were examined with transvaginal 3D gray-scale and power Doppler sonography on cycle days 4 to 8. We used a 6- to 12-MHz transducer. The ovarian volume, number and volume of antral follicles of 2 mm or larger, vascularization index, flow index, and vascularization-flow index were calculated using dedicated software. Results are presented separately for women with follicles of 2.0 to 10.0 mm and for those with at least 1 follicle larger than 10.0 mm for 3 age groups: 20 to 29, 30 to 34, and 35 to 39 years. RESULTS There were 214 women (71%) with follicles of 2.0 to 10.0 mm and 89 (29%) with follicles larger than 10.0 mm. In women with follicles of 2.0 to 10.0 mm, the right ovary was on average 0.8 cm3 larger and contained on average 1.2 more follicles than the left one. The ovarian volume, number of follicles, and total follicular volume decreased significantly with age in both ovaries (P = .000-.029): for the right ovary ovarian volume, the median (range) decreased from 8.4 (3.7-17.3) cm3 at 20 to 29 years to 6.5 (2.4-12.7) cm(3) at 35 to 39 years, the number of follicles from 14 (1-32) at 20 to 29 years to 8 (1-21) at 35 to 39 years, and the total follicular volume from 1.08 (0.01-3.10) cm3 at 20 to 29 years to 0.84 (0.03-2.00) cm3 at 35 to 39 years. The size of the largest follicle and the vascular indices manifested no clear changes with age in any ovary. In women with follicles larger than 10 mm, the number of follicles decreased with age in both ovaries. CONCLUSIONS We have elicited data representative of normal findings on 3D trans-vaginal sonography of ovaries in gynecologically asymptomatic white women of fertile age. Our gray-scale sonographic results may be used as reference values for general gynecology in populations similar to ours. Vascular indices must be interpreted with caution because of difficulties with standardization.
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Affiliation(s)
- Ligita Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital Malmö, S-20502 Malmö, Sweden.
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Potočnik B, Cigale B, Zazula D. Computerized detection and recognition of follicles in ovarian ultrasound images: a review. Med Biol Eng Comput 2012; 50:1201-12. [PMID: 23011079 DOI: 10.1007/s11517-012-0956-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 09/13/2012] [Indexed: 11/28/2022]
Abstract
Observing changes in females' ovaries is essential in obstetrics and gynaecological imaging, e.g., genetic engineering and human reproduction. It is particularly important to monitor the dynamics of ovarian follicles' growth, as only fully mature and grown follicles, i.e., the dominant follicles have a potential to ovulate at the end of a follicular phase. Gynaecologists follow this process in two dimensions, but recently three-dimensional (3-D) ultrasound examinations are coming to the fore. This paper surveys the existing computer methods for detection, recognition, and analyses of follicles in two-dimensional (2-D) and 3-D ovarian ultrasound recordings. Our study focuses on the efficiency, validation, and assessment of proposed follicle processing algorithms. The most important processing steps were identified in order to compare their performances. Higher ranking solutions are suggested for the so-called best algorithm for 2-D and 3-D ultrasound recordings of ovarian follicles. Finally, some guidelines for future research in this field are discussed, in particular for 3-D ultrasound volumes.
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Affiliation(s)
- Božidar Potočnik
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Smetanova ulica 17, 2000, Maribor, Slovenia.
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16
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Ovarian size and vascularization as assessed by three-dimensional grayscale and power Doppler ultrasound in asymptomatic women 20–39 years old using combined oral contraceptives. Contraception 2012; 86:257-67. [DOI: 10.1016/j.contraception.2011.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 12/21/2011] [Accepted: 12/21/2011] [Indexed: 11/22/2022]
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17
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Rouleau D, Case A, Gamelin A, Lim H, Baerwald A. A practical method for ultrasonographically monitoring the day-to-day growth of individual ovarian follicles in women undergoing assisted reproduction. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1004-1010. [PMID: 22502889 DOI: 10.1016/j.ultrasmedbio.2012.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 01/19/2012] [Accepted: 02/16/2012] [Indexed: 05/31/2023]
Abstract
The objective of this study was to validate the use of the nonidentity (NonID) method compared with the identity (ID) method for tracking the day-to-day growth of individual follicles in women undergoing ovarian stimulation for assisted reproduction. A retrospective observational study was conducted in 20 women during ovarian stimulation. Conventional 2-D transvaginal ultrasonography was used to monitor follicle growth every 2-3 days throughout stimulation. Video clips of both ovaries were obtained in sagittal and coronal planes at each visit. Standardized diameter measurements of all follicles ≥4 mm were made retrospectively from video clips. The growth profiles of all follicles that developed to ≥10 mm were determined using the ID and NonID methods. Using Lin's concordance statistics, we documented that agreement between methods was 91% for follicles <10 mm, 96% for follicles 10-15 mm and 99% for follicles >15 mm. Lin's concordance correlation coefficient between the two methods was 0.96 (standard error = 0.003). We concluded that the NonID method is a practical, effective tool for monitoring the day-to-day growth of individual ovarian follicles in women undergoing assisted reproduction.
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Affiliation(s)
- Desiree Rouleau
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Jayaprakasan K, Deb S, Batcha M, Hopkisson J, Johnson I, Campbell B, Raine-Fenning N. The cohort of antral follicles measuring 2-6 mm reflects the quantitative status of ovarian reserve as assessed by serum levels of anti-Müllerian hormone and response to controlled ovarian stimulation. Fertil Steril 2010; 94:1775-81. [PMID: 19931077 DOI: 10.1016/j.fertnstert.2009.10.022] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 10/08/2009] [Accepted: 10/13/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the relationship between serum anti-Müllerian hormone (AMH) and antral follicle size, and to ascertain which cohort of antral follicles is most predictive of the response to controlled ovarian stimulation during assisted reproduction treatment (ART). DESIGN Prospective study. SETTING University-based Assisted Conception Unit. PATIENT(S) One hundred thirteen women undergoing first cycle of ART. INTERVENTION(S) Transvaginal 3D-ultrasound assessment and venipuncture in the early-follicular phase of the menstrual cycle. MAIN OUTCOME MEASURE(S) Serum AMH levels, number of mature oocytes retrieved and poor ovarian response. RESULT(S) The antral follicle cohorts measuring 2 to 3 mm, >3 to 4 mm, >4 to 5 mm, and >5 to 6 mm were most significantly correlated with AMH (r = .30, .27, .30, and .41, respectively) and the number of mature oocytes retrieved (r = .28, .23, .29, and .34, respectively). Although these follicle cohorts of 2-6 mm were significant predictors of the number of mature oocytes retrieved on regression analysis, their discriminative ability (area under the curve [AUC]: 0.829) for the prediction of poor ovarian response was similar to total counts made using cohorts of 2 to 4 mm, 2 to 5 mm, 2 to 8 mm, and 2 to 10 mm (AUCs: 0.794, 0.812, 0.852, and 0.826, respectively). CONCLUSION(S) The number of antral follicles measuring 2 to 6 mm is most reflective of the quantitative ovarian reserve. However, the ability of this group of antral follicles to predict poor ovarian response appears similar to that of the follicular cohorts of 2 to 4 mm, 2 to 5 mm, 2 to 8 mm, and 2 to 10 mm.
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Affiliation(s)
- Kannamannadiar Jayaprakasan
- Nottingham University Research and Treatment Unit in Reproduction, Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom.
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Murai M, Takatori E, Omi H, Isurugi C, Honda T, Kumagai S, Shoji T, Oyama R, Yoshisaki A, Sugiyama T. Anti-Mϋllerian hormone and 3D-power Doppler histogram: markers of ovarian function with in vitro fertilization treatment. Reprod Med Biol 2010; 9:151-161. [PMID: 29699338 DOI: 10.1007/s12522-010-0051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 03/14/2010] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the ability of three-dimensional (3D) ultrasonography and anti-Mϋllerian hormone (AMH) to predict successful embryo development in patients undergoing in vitro fertilization (IVF) treatment. Methods We prospectively studied 28 patients undergoing IVF treatment, using 3D ultrasound Sono automatic volume calculation (AVC) and a 3D-power Doppler volume histogram. Sono AVC was used to automatically measure the number and volume of follicles. The volume histogram was used to measure the vascularization index (VI), flow index, and vascularization flow index in the ovaries. Serum AMH (S-AMH) was determined by enzyme immunoassay (ng/ml). Results The number of embryos isolated was 3.3 ± 2.8. The S-AMH of the patients who were under 35 years of age (0.570 ± 0.216 ng/ml) was higher than that in the patients over 40 years of age (0.377 ± 0.071 ng/ml; p = 0.0003). Principal component analyses determined that the quality of the embryo depended on the patients's age, S-AMH, and VI of the ovary. The receiver operating characteristic (ROC) curve showed that the cutoff for the S-AMH was 0.2855 ng/ml, and the optimal age of the patient was 32.5 years, when implanted with an embryo on day 16. Conclusions We demonstrated that investigating the relationships between the number of the embryo and ovarian function, using a combination of AMH with a volume histogram, might be useful to predict the response to IVF treatment.
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Affiliation(s)
- Masatoshi Murai
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Eriko Takatori
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Hideo Omi
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Chizuko Isurugi
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Tatsuya Honda
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Seisuke Kumagai
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Rie Oyama
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Akira Yoshisaki
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology Iwate Medical University 19-1 Uchimaru 020-8505 Morioka Iwate Japan
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Raine-Fenning N, Deb S, Jayaprakasan K, Clewes J, Hopkisson J, Campbell B. Timing of oocyte maturation and egg collection during controlled ovarian stimulation: a randomized controlled trial evaluating manual and automated measurements of follicle diameter. Fertil Steril 2010; 94:184-8. [DOI: 10.1016/j.fertnstert.2009.02.063] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 01/30/2009] [Accepted: 02/20/2009] [Indexed: 10/21/2022]
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21
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Deb S, Campbell BK, Clewes JS, Raine-Fenning NJ. Quantitative analysis of antral follicle number and size: a comparison of two-dimensional and automated three-dimensional ultrasound techniques. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:354-360. [PMID: 20069654 DOI: 10.1002/uog.7505] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To compare two-dimensional (2D) ultrasound imaging with automated three-dimensional (3D) ultrasound imaging for the measurement of antral follicle number and size. METHODS Twenty-four subjects aged < 40 years underwent transvaginal ultrasound examination (Voluson E8) in the early follicular phase of the menstrual cycle. A 2D ultrasound scan of both ovaries was performed; each antral follicle was identified and then measured by taking the mean of two diameters. A 3D ultrasound dataset of both ovaries was then acquired and analyzed using Sonography-based Automated Volume Count (SonoAVC). The time taken to measure the size of all antral follicles in both ovaries was recorded in seconds for each technique. Antral follicle size was recorded to the nearest millimeter and counts for each 1-mm group were obtained. Antral follicle counts were also grouped according to five predefined size categories: 2.0-5.0 mm, 2.0-6.0 mm, 2.0-8.0 mm, 2.0-9.0 mm and 2.0-10.0 mm. Limits of agreement (LOA) and a paired t-test or Wilcoxon signed ranks test were used to analyze the data depending on their distribution. RESULTS When antral follicle numbers were compared for each 1-mm follicle size group, 2D ultrasound imaging recorded more follicles measuring 3.0-3.99 mm (mean +/- SD, 4.11 +/- 3.70 vs. 2.63 +/- 2.31; P = 0.019) and 4.0-4.99 mm (mean +/- SD, 4.63 +/- 4.86 vs. 2.68 +/- 2.89; P = 0.013) than did SonoAVC. LOA were widest with follicles measuring 3.0-3.99 mm (LOA, 6.38 and -3.43) and 4.0-4.99 mm (LOA, 7.99 and -4.09). The antral follicle count in each of the five predefined size categories was significantly lower with SonoAVC than with 2D ultrasound imaging (P < 0.05). SonoAVC took significantly less time to measure the size and record the number of antral follicles than did 2D ultrasound imaging (mean +/- SD, 132.05 +/- 56.23 s vs. 324.47 +/- 162.22 s; P < 0.001). CONCLUSIONS Fewer antral follicles are evident overall when SonoAVC is used to analyze 3D ultrasound data. The clinical significance of this remains to be determined but the automated technique is significantly quicker than is making measurements using 2D ultrasound imaging.
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Affiliation(s)
- S Deb
- University of Nottingham, School of Clinical Sciences, Division of Human Development, Nottingham University Research and Treatment Unit in Reproduction (NURTURE), Nottingham, UK.
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22
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Rizzo G, Capponi A, Pietrolucci ME, Arduini D. Role of sonographic automatic volume calculation in measuring fetal cardiac ventricular volumes using 4-dimensional sonography: comparison with virtual organ computer-aided analysis. JOURNAL OF ULTRASOUND IN MEDICINE 2010; 29:261-70. [PMID: 20103798 DOI: 10.7863/jum.2010.29.2.261] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the agreement and reliability of virtual organ computer-aided analysis (VOCAL) and sonographic automatic volume calculation (sonoAVC) for measurements of ventricular volume from fetal heart data sets acquired by 4-dimensional sonography with spatiotemporal image correlation (STIC). METHODS We studied 45 volumes from fetuses with normal (n = 30) and abnormal (n = 15) hearts. Spatiotemporal image correlation data sets were frozen in end systole and end diastole, and ventricular volumes were measured with VOCAL and sonoAVC. The stroke volume was calculated from these measurements. Reliability and agreement of the two techniques were evaluated with intraclass correlation coefficients (ICCs), and proportionate Bland-Altman plots were constructed. The time necessary to complete the measurements with either technique was compared. Intraobserver and interobserver agreement of measurements was calculated. RESULTS All data sets could be measured with both techniques. A high degree of reliability was observed between VOCAL and sonoAVC (left ventricular stroke volume ICC, 0.978; 95% confidence interval [CI], 0.957-0.989; right ventricular stroke volume ICC, 0.985; 95% CI, 0.972-0.992). The time necessary to measure the stroke volume was significantly shorter with sonoAVC (2.8 versus 11.7 minutes; P < .0001) than with VOCAL. Bland-Altman tests showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle by the same observer or by 2 independent observers using either VOCAL or sonoAVC. CONCLUSIONS There was good agreement between cardiac volumes measured with VOCAL and sonoAVC. Sonographic automatic volume calculation represents a rapid technique for estimating fetal stroke volume and promises to become the method of choice.
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Affiliation(s)
- Giuseppe Rizzo
- Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Fatebenefratelli S. Giovanni Calabita Hospital, Isola Tiberina 89, 00186 Rome, Italy.
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Prospective evaluation of automated follicle monitoring in 58 in vitro fertilization cycles: follicular volume as a new indicator of oocyte maturity. Fertil Steril 2010; 93:616-20. [DOI: 10.1016/j.fertnstert.2009.02.058] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 02/10/2009] [Accepted: 02/18/2009] [Indexed: 11/23/2022]
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Borenstein M, Azumendi Perez G, Molina Garcia F, Romero M, Anderica JR. Gestational sac volume: comparison between SonoAVC and VOCAL measurements at 11 + 0 to 13 + 6 weeks of gestation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 34:510-514. [PMID: 19753656 DOI: 10.1002/uog.7342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To assess the novel three-dimensional (3D) tool, Sonography-based Automated Volume Count (SonoAVC) in the calculation of gestational sac volume at 11 + 0 to 13 + 6 weeks of gestation, to correlate the measurements with those obtained using Virtual Organ Computed-aided AnaLysis (VOCAL) and to study the reproducibility of SonoAVC volume calculation of this irregularly shaped structure. METHODS We acquired 3D volumes of the uterus in 65 pregnancies at 11 + 0 to 13 + 6 weeks of gestation. We performed volume calculation of the gestational sac, excluding the fetus and the placenta, using VOCAL with 15 degrees 12-step rotation. We then repeated the calculation with three different SonoAVC settings and compared both techniques. In 30 cases we assessed the reproducibility of the SonoAVC volume calculations. RESULTS In 95% of cases it was possible to calculate the gestational sac volume with SonoAVC. This volume increased with advancing gestation and the volumes were expressed as delta values to compare the measurements made with VOCAL and the three different SonoAVC settings. There was no difference between delta values of gestational sac volume calculated using VOCAL and SonoAVC with high and medium growth settings. Reproducibility analysis showed good results. CONCLUSION Gestational sac volume calculation is feasible with SonoAVC in most cases and does not differ from that performed using VOCAL. High and medium growth SonoAVC settings seem to be more accurate for gestational sac volume calculation, although larger studies are required for standardization of the technique. The reproducibility analysis showed similar results to those previously published.
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Affiliation(s)
- M Borenstein
- Centro Gutenberg, Prenatal Diagnosis Unit, Malaga, Spain.
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25
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Pistorius L, Stoutenbeek P, Visser GHA. First trimester neurosonoembryology with automated follicle tracking: Preliminary findings. J Matern Fetal Neonatal Med 2009; 22:949-51. [DOI: 10.1080/14767050902929388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Automated follicle tracking improves measurement reliability in patients undergoing ovarian stimulation. Reprod Biomed Online 2009; 18:658-63. [PMID: 19549444 DOI: 10.1016/s1472-6483(10)60010-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study tested the hypothesis that the automated assessment of a stimulated ovary, using 3D ultrasound and sono-AVC (automatic volume calculation), provides quicker analysis of follicular number and size than conventional 2D ultrasound, without any loss in measurement validity. Transvaginal ultrasound was performed on day 10 of stimulation in 89 prospectively recruited subjects undergoing IVF treatment. The number and mean diameter of follicles present in both ovaries was measured manually using 2D ultrasound. 3D data were then acquired and analysed using sono-AVC. Outcome measures included the number of follicles with a mean diameter >9 mm, >13 mm and >17 mm. The time taken for measurements and data acquisition was recorded. The two methods were compared using a paired t-test or the Wilcoxon signed rank test. Complete data were available for 82 subjects. There was no significant difference in the number of follicles with mean diameters >9 mm, >13 mm and >17 mm measured by either method. The total time taken for follicular measurements was significantly less (P < 0.01) for the automated 3D method (180.5 +/- 63.6 versus 236.1 +/- 57.1 s) which was associated with significantly less exposure to ultrasound (39.0 +/- 6.0 versus 236.10 +/- 57.1 s; P < 0.001). Automated 3D follicular measurements using sono-AVC provide a comparable but quicker assessment of follicle number and size.
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Broekmans FJM, de Ziegler D, Howles CM, Gougeon A, Trew G, Olivennes F. The antral follicle count: practical recommendations for better standardization. Fertil Steril 2009; 94:1044-51. [PMID: 19589513 DOI: 10.1016/j.fertnstert.2009.04.040] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 04/22/2009] [Accepted: 04/22/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To provide recommendations for the standardized use of the Antral follicle count (AFC) which is used to predict ovarian response to gonadotrophin stimulation during assisted reproductive technology treatment. However, the nature of the follicles that are visualized by ultrasound and the competence of the oocytes held within are largely unknown. In addition, there is considerable variability in the clinical definitions and technical methods used to count and measure antral follicles in both published studies and clinical practice. DESIGN AND SETTING In December 2007, specialist reproductive medicine clinicians and scientists attended a workshop in an effort to address these issues. Literature concerning the physiology and measurement of ovarian antral follicles was reviewed, clinical and technical considerations regarding antral follicle measurement were discussed, and an operational definition of AFC was developed. PATIENT(S) None. INTERVENTION(S) None. OUTCOME MEASURES Simple recommendations were established for the standardization of AFC assessment in routine clinical practice. The basic clinical and technical requirements required for AFC evaluation were agreed upon, and a systematic method of measuring and counting antral follicles in routine practice was proposed. CONCLUSION(S) The use of a standardized approach according to the practical recommendations for antral follicle counting as presented is encouraged in future clinical trials and routine practice. The authors also advocate a systematic evaluation of these recommendations as standardized study data become available.
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Affiliation(s)
- Frank J M Broekmans
- Department of Reproductive Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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Deb S, Batcha M, Campbell BK, Jayaprakasan K, Clewes JS, Hopkisson JF, Sjoblom C, Raine-Fenning NJ. The predictive value of the automated quantification of the number and size of small antral follicles in women undergoing ART. Hum Reprod 2009; 24:2124-32. [PMID: 19493874 DOI: 10.1093/humrep/dep204] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sono-automatic volume calculation (SonoAVC) automatically identifies and measures the dimensions of hypoechogenic areas within datasets acquired using three-dimensional ultrasound. The objective of this study was to evaluate the predictive value of automated antral follicle counts according to their relative sizes in women undergoing assisted reproduction treatment (ART). METHODS A total of 156 subjects aged < or =40 years with a baseline FSH < or =15 IU that undergo their first cycle of ART were prospectively recruited. SonoAVC was used to measure the datasets and record the number of antral follicles measuring < or =9 mm in diameter. These follicles were then grouped into subsets according to their relative sizes: < or =2.0, 2.1-4.0, 4.1-6.0, 6.1-8.0 and 8.1-9.0 mm. The primary outcome was viable pregnancy confirmed on ultrasound 5 weeks following embryo transfer. RESULTS A total of 142 subjects were included for analysis of primary end-point. Those subjects who conceived had significantly more antral follicles measuring < or =2 (P = 0.041) and 2.1-4.0 mm (P < 0.001) than those who had unsuccessful treatment. There were no significant differences between the groups in the number of antral follicles measuring 4.1-6.0 (P = 0.191), 6.1-8.0 (P = 0.203) and 8.1-9.0 mm (P = 0.601). Multiple logistic regression showed that antral follicles measuring 2.1-4.0 mm were an independent predictor of pregnancy [Exp(B) = 1.234, 95% CI = 1.092-1.491; P = 0.004; AUC = 0.693]. CONCLUSION SonoAVC provides automated measures of antral follicle number and size. Using this technique, the number of antral follicles measuring 2.1-4.0 mm in diameter is an independent, significant predictor of pregnancy following in vitro fertilization treatment.
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Affiliation(s)
- S Deb
- Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, UK.
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Lam PM, Raine-Fenning N. Polycystic ovarian syndrome: a misnomer for an enigmatic disease. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 33:621-627. [PMID: 19479676 DOI: 10.1002/uog.6414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Deb S, Jayaprakasan K, Campbell BK, Clewes JS, Johnson IR, Raine-Fenning NJ. Intraobserver and interobserver reliability of automated antral follicle counts made using three-dimensional ultrasound and SonoAVC. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 33:477-483. [PMID: 19212944 DOI: 10.1002/uog.6310] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess the reliability of automated measurements of the total antral follicle count (AFC) made using Sono-Automatic Volume Count (SonoAVC), and to compare these to two-dimensional (2D) and manual three-dimensional (3D) techniques. METHODS Fifty-five subjects aged under 40 years who had 3D transvaginal ultrasound examination in the early follicular phase of their menstrual cycle were prospectively recruited. 3D datasets were acquired and subsequently analyzed. The total AFC (2-10 mm antral follicles) was calculated by two observers using three independent methods: 2D real-time equivalent (2D-RTE), 3D manual multiplanar view (3D-MPV), and SonoAVC. For measurements made using SonoAVC, the initial automated count (sAVC-AA) was recorded and postprocessing (sAVC-PP) then applied to identify follicles that had been missed or incorrectly included. Intraclass correlation and limits of agreement were used to evaluate the methods. RESULTS The intra- and interobserver reliability of measurements of total AFC was best with SonoAVC with postprocessing followed by 3D-MPV and 2D-RTE. The initial count calculated by sAVC-AA missed follicles and this was reflected in the significantly lower mean total AFC (6.51 +/- 4.79) than that made after postprocessing techniques (sAVC-PP, 18.42 +/- 10.53, P < 0.001; 3D-MPV, 19.38 +/- 10.85, P < 0.001; and 2D-RTE, 19.26 +/- 10.55, P < 0.001). The mean total AFC became more comparable with postprocessing (sAVC-PP) but still remained significantly lower than counts made with 2D-RTE and 3D-MPV (P < 0.05). CONCLUSION SonoAVC with postprocessing is a reliable method for measuring total AFC. It takes longer to perform, because of the need for postprocessing, and obtains values that are lower than those obtained by the 2D and 3D-MPV techniques. However, the AFC obtained by sAVC-PP is likely to be lower because this method measures and color codes each follicle preventing recounting.
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Affiliation(s)
- S Deb
- Nottingham University Research and Treatment Unit in Reproduction (NURTURE), School of Human Development, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK.
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Cheong KB, Leung KY, Chan HY, Lee YP, Yang F, Tang MHY. Comparison of inter- and intraobserver agreement between three types of fetal volume measurement technique (XI VOCAL, VOCAL and multiplanar). ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 33:287-294. [PMID: 19248036 DOI: 10.1002/uog.6255] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To compare the new XI VOCAL (eXtended Imaging Virtual Organ Computer-aided Analysis) for three-dimensional (3D) ultrasound measurement of fetal volume with the conventional multiplanar technique and a rotational method using VOCAL. METHODS We acquired 3D volume datasets from 30 fetuses at 11-14 weeks of gestation using a commercially available ultrasound system. Fetal volume was calculated using XI VOCAL (with 5, 10, 15 and 20 slices), multiplanar (1-mm interval) and VOCAL (with 12 degrees, 18 degrees and 30 degrees rotation) techniques. The level of agreement for interobserver and intraobserver variability was determined and evaluated for all methods and reliability was assessed. RESULTS Fetal volume measurements obtained using XI VOCAL (10 slices) showed good correlation with those obtained using VOCAL (18 degrees) (r = 0.940, P = 0.076; intraclass correlation coefficient (ICC), 0.962 (95% CI, 0.920-0.982), P = 0.182), and XI VOCAL (15 slices) showed good correlation with VOCAL (12 degrees ) (r = 0.961, P = 0.092; ICC, 0.979 (95% CI, 0.957-0.990), P = 0.190). The mean difference between paired measurements by the XI VOCAL (10 slices) and VOCAL (18 degrees ) methods was 1.00 mL, while that by the XI VOCAL (15 slices) and VOCAL (12 degrees) methods was 0.90 mL. 95% limits of agreement were - 2.80 to 4.80 between XI VOCAL (10 slices) and VOCAL (18 degrees) and - 1.90 to 3.70 between XI VOCAL (15 slices) and VOCAL (12 degrees). There was a small difference in the time required to complete the fetal volume measurement between XI VOCAL and VOCAL when a similar number of slices or rotational steps was used (P < 0.05), XI VOCAL taking less time. CONCLUSION XI VOCAL (with 10, 15 and 20 slices) can be used interchangeably with the multiplanar technique (1-mm interval) for the measurement of fetal volume. XI VOCAL (10 slices) and VOCAL (18 degrees) can be used interchangeably, as can XI VOCAL (15 slices) and VOCAL (12 degrees), for the measurement of fetal volume.
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Affiliation(s)
- K B Cheong
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, Hong Kong, SAR China. cheong kah
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Rousian M, Verwoerd-Dikkeboom CM, Koning AHJ, Hop WC, van der Spek PJ, Exalto N, Steegers EAP. Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives. BJOG 2008; 116:278-85. [DOI: 10.1111/j.1471-0528.2008.02006.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tutschek B, Sahn DJ. Semi-automatic segmentation of fetal cardiac cavities: progress towards an automated fetal echocardiogram. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:176-180. [PMID: 18634109 DOI: 10.1002/uog.5403] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop a novel application of a tool for semi-automatic volume segmentation and adapt it for analysis of fetal cardiac cavities and vessels from heart volume datasets. METHODS We studied retrospectively virtual cardiac volume cycles obtained with spatiotemporal image correlation (STIC) from six fetuses with postnatally confirmed diagnoses: four with normal hearts between 19 and 29 completed gestational weeks, one with d-transposition of the great arteries and one with hypoplastic left heart syndrome. The volumes were analyzed offline using a commercially available segmentation algorithm designed for ovarian folliculometry. Using this software, individual 'cavities' in a static volume are selected and assigned individual colors in cross-sections and in 3D-rendered views, and their dimensions (diameters and volumes) can be calculated. RESULTS Individual segments of fetal cardiac cavities could be separated, adjacent segments merged and the resulting electronic casts studied in their spatial context. Volume measurements could also be performed. Exemplary images and interactive videoclips showing the segmented digital casts were generated. CONCLUSION The approach presented here is an important step towards an automated fetal volume echocardiogram. It has the potential both to help in obtaining a correct structural diagnosis, and to generate exemplary visual displays of cardiac anatomy in normal and structurally abnormal cases for consultation and teaching.
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MESH Headings
- Algorithms
- Cardiac Volume/physiology
- Echocardiography, Doppler, Color/methods
- Echocardiography, Doppler, Color/standards
- Echocardiography, Three-Dimensional/methods
- Echocardiography, Three-Dimensional/standards
- Female
- Fetal Heart/diagnostic imaging
- Gestational Age
- Heart Ventricles/diagnostic imaging
- Humans
- Hypoplastic Left Heart Syndrome/diagnostic imaging
- Image Interpretation, Computer-Assisted
- Infant, Newborn
- Male
- Pregnancy
- Retrospective Studies
- Software
- Transposition of Great Vessels/diagnostic imaging
- Ultrasonography, Prenatal/methods
- Ultrasonography, Prenatal/standards
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Affiliation(s)
- B Tutschek
- Department of Obstetrics, University Hospital of Berne, Berne, Switzerland.
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Rizzo G, Capponi A, Pietrolucci ME, Arduini D. Sonographic automated volume count (SonoAVC) in volume measurement of fetal fluid-filled structures: comparison with Virtual Organ Computer-aided AnaLysis (VOCAL). ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:111-2. [PMID: 18536064 DOI: 10.1002/uog.5387] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Raine-Fenning N, Jayaprakasan K, Clewes J, Joergner I, Bonaki SD, Chamberlain S, Devlin L, Priddle H, Johnson I. SonoAVC: a novel method of automatic volume calculation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 31:691-696. [PMID: 18484679 DOI: 10.1002/uog.5359] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To assess the ability of the new software SonoAVC to measure follicular volume and to compare these volume calculations with those made by conventional methods. METHODS Three-dimensional ultrasound imaging was used to acquire volumetric data from the ovaries of 51 women undergoing controlled ovarian stimulation as part of in-vitro fertilization treatment. All assessments were performed on the day of oocyte retrieval and the true volume of each follicle was ascertained by manual measurement of the follicular aspirate. SonoAVC was used to automatically measure the volume of follicles and to provide three perpendicular diameters (xyz diameters), which were used to estimate volume using the sphere formula. The sphere formula was also used to estimate the volume from manual measurements of follicle diameter derived from conventional two-dimensional (2D) displays. Virtual Organ Computer-aided AnaLysis (VOCAL) was also used to measure volume, and the validity of each technique was compared using limits of agreement. RESULTS Two hundred and twenty-four follicles with a mean follicular volume of 3.7 (range, 0.4-16.2) cm(3) were studied. SonoAVC provided highly accurate automatic follicular volume measurements in all cases. Volume estimations made from the automatic maximal follicular diameter measurements (xyz diameters) were less valid. VOCAL proved highly valid but was less accurate than SonoAVC. Volumes estimated from manually derived follicular diameter measurements were the least accurate. CONCLUSIONS SonoAVC provides highly valid, automatic measurements of follicular volume. These measurements are more accurate than volumes estimated from 2D manual measurements, automated measurements of follicular diameter and those calculated using VOCAL.
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Affiliation(s)
- N Raine-Fenning
- School of Human Development, University of Nottingham, Nottingham, UK.
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