TrueVue transillumination volume rendering for three-dimensional transoesophageal echocardiography in interventional imaging

Supplemental Digital Content is available in the text Aims The aim of the present article is to address the advantages of real-time TrueVue transillumination rendering for three-dimensional transoesophageal echocardiography in the context of echocardiographic procedural guidance for structural interventions for several procedural concerns. Methods Procedures in which transillumination imaging was used during at least one step of the whole intervention were retrospectively collected; the loops were reviewed by an experienced imaging specialist and the most important concerns imaged in the loops were listed. The apparent added value of transillumination for each of these concerns was scored independently by two imager specialists, and their agreement was derived. Results Between January and June 2019, 50 procedures were performed in our centre. Transillumination imaging was used in 64% of these cases. Considering all the loops the added value of transillumination compared with the conventional rendering was scored greater than 3 in a Likert scale in 87% of analysed loops by both the operators with a good agreement (κ = 0.47, P = 0.001). A different level of perceived advantage and agreement was observed between three image features that improved: substantial agreement (κ = 0.652, P = 0.001) for enhancing the contrast between structures and cavities (n = 24 loops); good agreement for the contrast between different structures (κ = 0.588, P = 0.002) (n = 37 loops); moderate agreement for the perception of interaction between the device and structures (κ = 0.3, P = 0.027) (n = 7 loops). Conclusion The use of new volume-rendering techniques in interventional imaging may be useful especially for solving the concerns regarding the cavity-structure contrast.