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When the first commercial 3D ultrasound device (Combison 330, Kretztechnik, Zipf, Austria) became available in 1989 (▶ Fig. 1) [1], no one could have predicted just how important 3D ultrasound would become. While only the multiplanar mode with visualization of three orthogonal image planes was initially available, various imaging modes have been developed in the last three decades [2 – 11] allowing a wide range of imaging options in comparison to 2D ultrasound. Today, anatomical structures can be visualized with almost photographic quality (▶ Fig. 2a, b) [12 – 16]. The rapid advances in the field of computer technology and the design of special 3D probes have undoubtedly played an important role in this process [2, 7]. However, all of these developments were only possible as a result of the vision of individual ultrasound companies, the dedicated work of engineers, and the ongoing collaboration between developers and users of 3D ultrasound in the clinical routine. Nonetheless, the diagnostic potential of 3D/4D ultrasound has still not yet been recognized in many countries and the method is only used in prenatal imaging to produce nice images of fetal faces or as baby TV for parents-to-be [17, 18]. Of course, there is a learning curve involved in being able to effectively utilize all that 3D ultrasound has to offer. Precise control of image planes, surface images of outer and inner surfaces, transparent images, 3D display of vessels in fetuses and tumors, the ability to perform virtual examination of stored volumes [7, 11] not requiring the patient to be present, and loss-free long-term storage of volumes [2, 11] represent such major advantages that experienced ultrasound examiners can’t imagine being without 3D ultrasound. Of course, many diagnoses can also be made using 2D ultrasound. However, areas of interest can only be visualized on individual image planes. In contrast, 3D ultrasound offers not only simultaneous visualization of multiple image planes as in CT and MRI but also the demonstration of reconstructed image planes that cannot be visualized or can only be visualized less effectively with conventional 2D ultrasound. Moreover, 3D ultrasound allows the 3D display of structures that can be assessed more clearly in rotation mode and using movable light sources [11]. 3D images are also easier for patients to understand than individual sectional planes. 3D ultrasound also has major advantages for ultrasound training [7, 11]. A volume containing a fetal abnormality or a tumor can be copied multiple times and loaded on numerous external workstations. As a result, multiple examiners can examine a volume with identical content at the same time. Finally, stored volumes are also suitable for data transfer via the Internet in order to obtain a second opinion from an expert. Telemedicine is important particularly in countries without close access to a specialized center. Prof. Dr. Eberhard Merz Prof. Dr. Rabih Chaoui Editorial

30-year anniversary of ultrasound: Clinical use of 3D ultrasound in obstetrics and gynecology (1989–2019)