Nuchal translucency thickness measurement: repeatability using a virtual ultrasound scanner.
AIM: To use a PC-based virtual ultrasound scanner (VirUS) in the investigation of inter- and intraoperator nuchal translucency (NT) thickness measurement repeatability of experienced ultrasound operators. METHODS: Realistic fetal ultrasound images of defined NT thickness were simulated with VirUS with emulation of scanner gain and time-gain compensation and gain-dependent echo size changes. A set of 50 images was generated with uniformly distributed NT thickness (range, 1-5 mm at 1-mm intervals) and translucency angle (mean +/- standard deviation of +/- 2.52 degrees +/- 1.85 degrees about the horizontal). Operators (n = 13) measured NT thickness in the image set on three occasions separated by at least 1 day, giving 150 measurements per operator (total measurements, 1950). RESULTS: Inter- and intraoperator repeatabilities were +/- 0.41 mm and +/- 0.22 mm, respectively (at the 95% confidence level). There were significant correlations between repeatability and mean measured NT thickness (r = - 0.72, P = 0.005 at 4-mm interval), between gain and mean measured NT thickness (P </= 0.002, n = 8/13) and between gain and repeatability coefficient (P < 0.01, n = 6/13). DISCUSSION: VirUS provides a consistent NT audit environment and demonstrates the need to both optimize repeatability vs. mean measured thickness and to set gain consistently. The technique has potential in operator training.