Imaging methodology and protocols for three-dimensional echocardiography

PURPOSE OF REVIEW: Three-dimensional echocardiography (3DE) is an additional ultrasound modality that is poised to become an integral part of the routine echocardiogram. Incorporating 3DE into clinical daily practice continues to be a challenge for many laboratories. The following review will focus on workflow processes related to methodology and protocols in order to incorporate 3DE into clinical practice. RECENT FINDINGS: Several studies have shown the clinical utility and feasibility of both transthoracic and transesophageal 3DE. In addition, many centers performing 3DE studies utilize a focused 3DE protocol as opposed to a full 3DE protocol. A majority of the studies noted limitations with respect to artifacts inherent in gated imaging and preferred real-time 3DE or rather volume imaging. A recurrent message from several recent publications is that the ultimate success and widespread clinical application of 3DE will rely mainly on improved 3D image resolution and volume rates. SUMMARY: Continuous technology improvements have led to real-time full-volume 3D imaging that is no longer prone to the artifact issues encountered with gated 3D imaging. Additional improvements to 3DE image quality and time-saving automatic quantitative analysis tools will continue to define the emerging role for routine 3DE.