Novel Methods in the Diagnosis of PCOS: The Role of 3D Ultrasonographic Modalities

Abstract

Polycystic ovary syndrome (PCOS) is a common and complicated endocrine disorder, with its diagnosis based on clinical, laboratory and imaging criteria. The latter is usually assessed via two-dimensional ultrasound; however, the advent of three-dimensional ultrasound, along with three-dimensional power Doppler (3D-PD) could offer more accurate diagnoses and further our understanding of PCOS pathophysiology. Three-dimensional ultrasound (3D-US) has already been used successfully in many fields of gynecology. It offers improved image quality with stored data that can be processed either manually or automatically to assess many parameters useful in PCOS assessment, such as ovarian volume, number of follicles and vascular indices. The examination requires minimal time as data is assessed in post-processing, thus being more tolerable for the patient. 3D-US parameters are generally increased in PCOS patients when compared to controls and 2D measurements, with studies showing improved diagnostic performance, though that remains inconclusive. 3D transrectal ultrasound is more accurate in the diagnosis of virgin PCOS patients than the modalities currently available in that subgroup. Overall, though with some limitations, 3D-US is a promising diagnostic method in the assessment of PCOS which, regardless of diagnostic accuracy, can undoubtedly offer many practical advantages, more objective and reliable measurements, potentially improving PCOS diagnosis standardization.