From Sweeps to Volumes: 3D Multiscan Stitching Enables Operator-Independent, Large-Area Abdominal Ultrasound—A Phantom-and-Patient Feasibility Study

Conventional ultrasound (conUS) is operator-dependent, limiting reproducibility. Tomographic three-dimensional ultrasound processing (t3DUS) offers a potential solution by creating standardised data volumes similar to cross-sectional imaging. However, since abdominal organs often extend beyond the transducers’ angle of view, combining multiple adjacent volumes is necessary. First, the feasibility of applying a volume-stitching algorithm (PIUR Imaging, Vienna, Austria) to t3DUS images was evaluated using a standardised ultrasound phantom. Then, t3DUS was prospectively assessed in healthy volunteers and patients with liver diseases, comparing its image quality and diagnostic value to conUS. Finally, t3DUS was applied to a neonatal torso to explore potential use cases. Precise alignment of adjacent 3D image volumes on the ultrasound phantom yielded excellent results. In 22 healthy subjects and 22 patients with focal or parenchymal liver diseases, up to four adjacent abdominal scans were seamlessly merged into a continuous 3D volume, effectively illustrating both focal liver lesions and diffuse liver disease characteristics. The tomographic images from the neonatal ultrasound torso further underlined the imaging capabilities of t3DUS. In conclusion, tomographic acquisition and data processing techniques for abdominal ultrasound images are feasible and provides standardised, examiner-independent image datasets. However, technical optimisation and simplification of the acquisition process are necessary.