Abstract
Transillumination (TI) is a new 3D rendering tool that uses a freely movable virtual light source to enhance depth, contours, and image detail. The TI model was recently modified to allow the operator adjust the degree of transparency of both cardiac and extra-cardiac structures. While the addition of transparency was shown to significantly improve quality in 3D transesophageal imaging, this has not yet been shown for transthoracic (TTE) imaging. We prospectively studied 35 patients who underwent clinically indicated TTE with standard 3D acquisition, as well as TI with and without transparency. Six experienced echocardiographers were shown images of all three display types in random order. Each image was scored independently using a Likert Scale while assessing each of the following aspects: ability to identify anatomy or pathology, depth perception, degree of anatomic detail, and border delineation. All experts perceived an incremental value of the transparency mode, compared to TI without transparency and standard 3D rendering, in terms of ability to identify anatomy or pathology (4.15 ± 0.97 vs. 3.88 ± 0.99 vs. 2.52 ± 1.41, p < 0.01), depth perception (4.33 ± 0.78 vs. 3.88 ± 0.82 vs. 2.29 ± 1.07, p < 0.01), degree of anatomic detail (4.08 ± 1.0 vs. 3.89 ± 0.79 vs. 2.31 ± 1.08, p < 0.01), and border delineation (4.44 ± 0.80 vs. 3.90 ± 0.78 vs. 2.42 ± 1.13, p < 0.01). Compared to standard 3D and TI renderings of TTE images, the addition of transparency significantly improves both image quality and diagnostic confidence.
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Acknowledgements
Dr. Karagodin is supported by the NIH T32 Cardiovascular Sciences Training Grant (T32 HL007381). Dr. Singulane received a grant from the Brazilian Society of Cardiology, Department of Cardiovascular Imaging.
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RML conceived of the manuscript. IK drafted the manuscript and compiled the table and figures. MY acquired the images. AD, LR, AS, KA, JMD, CCS, MH, EK, ARP, and VM provided critical revisions and important intellectual content to the manuscript.
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Dr. Lang has received a research grant from Philips Healthcare for other unrelated studies. Ms. Rivera and Mr. Dow are full-time employees of Philips Healthcare. The remaining authors have nothing to disclose.
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This research study was conducted retrospectively from echocardiographic images obtained for clinical purposes. The study was approved by the IRB at the University of Chicago with a waiver of consent.
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Karagodin, I., Yamat, M., Dow, A. et al. Utility of transillumination and transparency renderings in 3D transthoracic imaging. Int J Cardiovasc Imaging 38, 141–147 (2022). https://doi.org/10.1007/s10554-021-02388-9
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DOI: https://doi.org/10.1007/s10554-021-02388-9