Kannamannadiar Jayaprakasan MBBS, Presenter: Nothing to Disclose

Jeanette S. Clewes, Abstract Co-Author: Nothing to Disclose

Ian R. Johnson, Abstract Co-Author: Nothing to Disclose

Nick Raine-Fenning, Abstract Co-Author: Nothing to Disclose

Prospective study comparing the interobserver reliability of antral follicle counts (AFCs), an important determinant of ovarian reserve, made using real-time 2D ultrasound to those made from 3D stored data following their real-time acquisition.

Two observers conducted transvaginal ultrasound examinations in 40 different subjects in the early follicular phase of the menstrual cycle. A measurement of the total number of antral follicles measuring 2-10 mm diameter was made using real-time 2D and the time taken recorded. A 3D volume was then acquired from each ovary and stored for subsequent off-line analysis using the multiplanar view. The time taken for each step was recorded and the total time calculated. Intraclass correlation coefficient (ICC) and limits of agreement (LOA) were used to assess interobserver measurement reliability.

The mean AFC was the same when measured in real-time 2D (17.11 ± 10.46) or following the acquisition of volumetric data and subsequent 3D analysis (17.97 ± 11.81). The interobserver reliability of measurements was significantly better when made using 3D than with real-time 2D ultrasound as indicated by a higher ICC (0.975; 0.949-0.988 versus 0.996; 0.991-0.998 p<0.01) and a narrower interval between the upper and lower LOA (3.14 to -2.89 versus 6.94 to -5.91). Whilst the total time taken was significantly longer for the 3D technique (249.8 ± 57.7 secs versus 116.2 ± 24.8 secs, p<0.001) the time spent with the subject was significantly less for 3D than 2D (45.7 ± 6.9 versus 116.2 ± 24.8, p<0.001).

3D ultrasound improves the interobserver reliability of antral follicle counts. This is at the expense of time overall but the duration of the actual ultrasound examination and patient exposure is significantly reduced.

The AFC is most reliably evaluated using 3D ultrasound which allows for a significant reduction in scanning time. This facilitates an increase in work flow and clinical throughput.

Jayaprakasan, K, Clewes, J, Johnson, I, Raine-Fenning, N, Three-dimensional Ultrasound Facilitates Increased Clinical Work Flow and Improves the Interobserver Reliability of Antral Follicle Counts.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012488.html