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A new method for 3-D ultrasound volume reconstruction using tracked freehand 3-D ultrasound is proposed. The method is based on solving the forward volume reconstruction problem using direct interpolation of high-resolution ultrasound B-mode image frames. A series of ultrasound B-mode image frames (an image series) is acquired using the freehand scanning technique and position sensing via optical tracking equipment. The proposed algorithm creates additional intermediate image frames by directly interpolating between two or more adjacent image frames of the original image series. The target volume is filled using the original frames in combination with the additionally constructed frames. Compared with conventional volume reconstruction methods, no additional filling of empty voxels or holes within the volume is required, because the whole extent of the volume is defined by the arrangement of the original and the additionally constructed B-mode image frames. The proposed direct frame interpolation (DFI) method was tested on two different data sets acquired while scanning the head and neck region of different patients. The first data set consisted of eight B-mode 2-D frame sets acquired under optimal laboratory conditions. The second data set consisted of 73 image series acquired during a clinical study. Sample volumes were reconstructed for all 81 image series using the proposed DFI method with four different interpolation orders, as well as with the pixel nearest-neighbor method using three different interpolation neighborhoods. In addition, volumes based on a reduced number of image frames were reconstructed for comparison of the different methods? accuracy and robustness in reconstructing image data that lies between the original image frames. The DFI method is based on a forward approach making use of a priori information about the position and shape of the B-mode image frames (e.g., masking information) to optimize the reconstruction procedure and to reduce com- utation times and memory requirements. The method is straight-forward, independent of additional input or parameters, and uses the high-resolution B-mode image frames instead of usually lower-resolution voxel information for interpolation. The DFI method can be considered as a valuable alternative to conventional 3-D ultrasound reconstruction methods based on pixel or voxel nearest-neighbor approaches, offering better quality and competitive reconstruction time.