Abstract
Recent advances in 3D ultrasound technology have resulted in the development of specific software such as VOCAL (Virtual Organ Computer-aided AnaLysis program) and SonoAVC (Sonographic-based Automated Volume Count) (GE Healthcare, Austria) that allow automatic measures of volumes. These software tools have several applications in gynecology as well as in other medical specialties, but the most widespread is the measurement of follicular diameters and volumes during ovarian stimulation in patients undergoing in vitro fertilization (SonoAVCfollicle). More recently, a specific software to evaluate antral follicles has been developed, called SonoAVCantral.
Advantages of this technology are undeniable when evaluating multifollicular ovaries; it clearly saves time and elaborates an extensive report with additional information of every single follicle. From the patient’s point of view, it has several benefits. They spend less time in the waiting room, the exploration is shorter, and, at the same time, the visualization of the ovary with this technology makes it easier to follow follicular growth and understand how the treatment is going.
The more promising information of the report is follicular volume since it is closer to the real size of the follicle. This fact must be appreciated because it gives us the opportunity to make clinical decisions based on follicular volumes rather than diameters, making treatments highly individualized. Studies in our laboratory have shown that follicles with volumes greater than 0.7 cc are associated with mature oocytes, and this information can be helpful to decide the day of trigger.
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This video shows how the 3D box is adjusted to cover the larger diameter of the ovary. Subsequently, the automatic acquisition is made, while the probe stands still (MP4 9614 kb)
Over the multiplanar view of the ovary, the ROI (region of interest) is adjusted, as close as possible to the limits of the ovary, before the automatic volume calculation begins. In a few seconds, the results are shown with every follicle color-coded. The results are reviewed manually scrolling through each plane adding or removing follicles. In this case, some follicles (numbers 3 and 7) extend beyond the limits of the ovary, so the “cut” option is used on plane C. Finally, a 3D representation of the stimulated ovary is shown on a rotational video (MP4 46104 kb)
SonoAVC follicle post-processing work (MP4 68495 kb)
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Rodrıguez-Fuentes, A., Hernández, J., Rouleau, J.P., Palumbo, A. (2019). SonoAVC (Sonographic-Based Automated Volume Count). In: Stadtmauer, L., Tur-Kaspa, I. (eds) Ultrasound Imaging in Reproductive Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-16699-1_17
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