The experimental study for sonographic diagnosis and treatment of metastatic lymph nodes using 3D image reconstruction of intranodal vascularity

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As a diagnostic method for metastatic lymph nodes, sonography has become a modality of choice. It has been reported these days that the diagnostic accuracy could be improved when not only the internal echoes by B-mode sonography but also the vascularity by color Doppler sonography were evaluated. However, it is sometimes difficult to differ the hilar pattern in normal nodes from the aberrant pattern in metastatic lymph nodes on two-dimensional images. Therefore, in order to make more exact diagnosis, we performed this study to establish the system which enabled to show the intranodal vascularity as three-dimensional images.At first we made images of rat submandibular glands, as they are about the same size as human cervical lymph nodes. Then we scanned human chronic lymphadenitis of a volunteer. As a sonographic diagnostic system we used Sequoia 512 (Acuson, co; USA)The sonograophic probe was set on the stage, it was moved in one direction with 0.5mm intervals. We made cine images for 3 seconds at each position, which included about 70 static images. These data were transferred to a personal computer with a MO disc. The three-dimensional image reconstruction was performed with the Perl API, and the volume rendering was performed with VolVis. The vascularity and the other soft tissue were expressed in warm colors and in gray-scale, respectively, like original sonographic images. The opacity of vascularity was set at 0.8, and that of the other soft tissue was set depending on their volume, in order to emphasize the vascularity.The problems to be solved are; 1. Improvement of the fixation apparatus in order to be applied to every position, 2. Reduction of reconstruction time, 3. More accurate setting of brightness and opacity, 4. Extraction of outline of rat submandibular glands and human lymph nodes, and 5. Extraction of the real vascularity without noises.