Follicle aspiration with interactive three-dimensional digital imaging (Voluson): a step toward real-time puncturing under three-dimensional ultrasound control.
OBJECTIVE
To evaluate the possibility of performing puncturing procedures under three-dimensional ultrasound (US) control in close to real time using a new commercially available system and to describe the technique.


METHODS
Descriptive case study.


METHODS
Private outpatient infertility clinic.


METHODS
A volunteer undergoing IVF-ET treatment.


METHODS
Transvaginal needle-guided aspiration of 10 follicles using a newly developed US machine with a built-in rapid and powerful calculation software program for three-dimensional interactive volume and flow translation during operation. Interactive three-dimensional imaging was carried out during the aspiration of each follicle.


METHODS
The delays caused by volume acquisition and the search for the needle tip with and without "power Doppler" were estimated and compared.


RESULTS
Oocyte recovery was successful from all follicles. There was a mean (+/-SD) delay of 5.00 +/- 1.22 seconds from coasting to resuming real-time US scanning during interactive volume calculation and the search for the needle tip in the three-dimensional mode. This did not delay the procedure remarkably but enabled the precise localization of both the needle and its tip after each penetration. The integration of flow signals allowed an impressive color-coded demonstration of the needle within the tissue, but the delay was significantly longer for color-coded volume acquisition (18.40 +/- 4.56 seconds).


CONCLUSIONS
Recent technology enables the performance of three-dimensional puncture procedures in close to real time; this technology is demonstrated for follicle punctures but will be of more importance in fields such as fetal medicine, oncology, and surgery.
Institut für Sterilitätsbetreuung, Vienna, Austria. wilfried.feichtinger@univie.ac.at
W
W
Feichtinger
D003199:Computer Systems; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D009865:Oocytes; D011677:Punctures; D012815:Signal Processing, Computer-Assisted; D013396:Suction; D018615:Ultrasonography, Doppler, Color