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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:155-162 • 0278-4297

Evaluation of the Accuracy of 3-Dimensional Ultrasonography of the Kidney Using an In Vitro Renal Model

Babbin S. John, MRCS, David Rowland, MSc, Uday Patel, MRCP, FRCR, James Pilcher, MRCP, FRCR, Ken Anson, MS, FRCS and Dariush Nassiri, MSc, PhD, FIPEM, CSci

Departments of Urology (B.S.J., K.A.), Medical Physics (D.R., D.N.), and Radiology (U.P., J.P.), St George’s Hospital, London, England.

Address correspondence to Babbin S. John, MRCS, 79 Queens Rd, Flat 2, London E11 1BA, England. E-mail: babbinj{at}yahoo.com

Objective. Three-dimensional ultrasonography (3DUS) has recently become a reality because of advances in ultrasound probes and machine processing ability. We have developed an anthropomorphic phantom of the human loin to assess both the accuracy of 3DUS of the kidney and its potential usefulness for training in ultrasonographically guided percutaneous renal intervention. Methods. The model was built with easily available and inexpensive materials such as agar and latex with known ultrasonographic properties. The accuracy of 2-dimensional ultrasonography (2DUS) and 3DUS was assessed by measuring the dimensions of the pelvicalyceal system (PCS) ultrasonographically (pelvis width and calyx diameters) and then comparing these with measurements obtained at the time of construction. Radiology interventional trainees then punctured the PCS with 2DUS and 4-dimensional ultrasonographic (real-time/time-resolved 3DUS) guidance and reported the phantom’s performance. Results. The 3-dimensional nature of the model’s PCS could be clearly visualized on 2DUS and 3DUS, and the scan characteristics were very similar to those in real life. Measurements using 3DUS proved to be closer to the true dimensions of the model’s PCS than those using 2DUS. The mean error percentage for 2DUS measurements was –10.2%, and that for 3DUS was –2.2% (P < 0.0001). Interventional trainees were satisfied with the "tissue feel" and level of difficulty posed on puncturing the phantom. Conclusions. Three-dimensional ultrasonography proved to be more accurate than 2DUS for intrarenal measurements using this in vitro renal model. Three-dimensional ultrasonography has the potential to ease diagnostic renal scanning with the ability to further scrutinize and postprocess the scanned volumes. The model was realistic in its anthropomorphic properties and simulated human tissue during puncture.

Key Words: imaging phantoms • interventional ultrasonography • kidney calices • kidney pelvis • measurement • 3-dimensional imaging • ultrasonography

Abbreviations: 4DUS; 4-dimensional ultrasonography • MPR, multi-planar reformatted • PCS, pelvicalyceal system • TE, tissue-equivalent • 3DUS, 3-dimensional ultrasonography • 2DUS, 2-dimensional ultrasonography

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.