Objectives: Three-dimensional (3D) ultrasound is being used increasingly to acquire and subsequently quantify power Doppler data within the clinical setting. One proprietary software package calculates three 3D vascular indices: the vascularization index (VI), the flow index (FI), and the vascularization flow index (VFI). Our aim was to evaluate how different settings affect the Doppler signal in terms of its quantification by these three indices within a 3D dataset.
Methods: A computer-driven 'flow phantom' was used to continuously pump a nylon particle-based blood mimic (Orgasol(trade mark)) around a closed system through a C-flex(trade mark) tube embedded in an agar-based tissue mimic. The test tanks were insonated with a modified 3D transvaginal 4-8-MHz ultrasound transducer (V530D) and power Doppler data were acquired over a series of different settings. Each experiment involved the manipulation of just one Doppler setting in order to study it in isolation.
Results: As expected, all of the power Doppler settings, when altered, were found to effect significant changes (P < 0.05) in the VI, FI and VFI. The gain and signal power had the greatest effect, producing no Doppler signals at the lowest settings and the highest recordable indices at the maximum settings. The pulse repetition frequency (PRF) was the next most influential setting but a Doppler signal was seen and measurable at all of the different settings. The other Doppler settings had a much less profound effect on the vascular indices, with subtle but significantly different measures across the full range of settings. The speed of data acquisition was also found to affect the vascular indices, all of which were reduced when the fast mode was used although the only significant effect was on the VFI.
Conclusions: The VI, FI and VFI are all affected significantly by variations in power Doppler settings and by the speed of acquisition. The gain and signal power have the greatest effect on the power Doppler signal, followed closely by the PRF. The other settings and speed of acquisition also influence the signal, but to a much lesser degree. It is essential to maintain Doppler settings if any meaningful comparisons are to be made within and between subjects.