A framework for analysis of linear ultrasound videos to detect fetal presentation and heartbeat.

Confirmation of pregnancy viability (presence of fetal cardiac activity) and diagnosis of fetal presentation (head or buttock in the maternal pelvis) are the first essential components of ultrasound assessment in obstetrics. The former is useful in assessing the presence of an on-going pregnancy and the latter is essential for labour management. We propose an automated framework for detection of fetal presentation and heartbeat from a predefined free-hand ultrasound sweep of the maternal abdomen. Our method exploits the presence of key anatomical sonographic image patterns in carefully designed scanning protocols to develop, for the first time, an automated framework allowing novice sonographers to detect fetal breech presentation and heartbeat from an ultrasound sweep. The framework consists of a classification regime for a frame by frame categorization of each 2D slice of the video. The classification scores are then regularized through a conditional random field model, taking into account the temporal relationship between the video frames. Subsequently, if consecutive frames of the fetal heart are detected, a kernelized linear dynamical model is used to identify whether a heartbeat can be detected in the sequence. In a dataset of 323 predefined free-hand videos, covering the mother's abdomen in a straight sweep, the fetal skull, abdomen, and heart were detected with a mean classification accuracy of 83.4%. Furthermore, for the detection of the heartbeat an overall classification accuracy of 93.1% was achieved

Confident head circumference measurement from ultrasound with real-time feedback for sonographers

Manual estimation of fetal Head Circumference (HC) from Ultrasound (US) is a key biometric for monitoring the healthy development of fetuses. Unfortunately, such measurements are subject to large inter-observer variability, resulting in low early-detection rates of fetal abnormalities. To address this issue, we propose a novel probabilistic Deep Learning approach for real-time automated estimation of fetal HC. This system feeds back statistics on measurement robustness to inform users how confident a deep neural network is in evaluating suitable views acquired during free-hand ultrasound examination. In real-time scenarios, this approach may be exploited to guide operators to scan planes that are as close as possible to the underlying distribution of training images, for the purpose of improving inter-operator consistency. We train on freehand ultrasound data from over 2000 subjects (2848 training/540 test) and show that our method is able to predict HC measurements within 1.81±1.65 mm deviation from the ground truth, with 50% of the test images fully contained within the predicted confidence margins, and an average of 1.82±1.78 mm deviation from the margin for the remaining cases that are not fully contained

A supervised texton based approach for automatic segmentation and measurement of the fetal head and femur in 2D ultrasound images

This paper presents a supervised texton based approach for the accurate segmentation and measurement of ultrasound fetal head (BPD, OFD, HC) and femur (FL). The method consists of several steps. First, a non-linear diffusion technique is utilized to reduce the speckle noise. Then, based on the assumption that cross sectional intensity profiles of skull and femur can be approximated by Gaussian-like curves, a multi-scale and multi-orientation filter bank is designed to extract texton features specific to ultrasound fetal anatomic structure. The extracted texton cues, together with multi-scale local brightness, are then built into a unified framework for boundary detection of ultrasound fetal head and femur. Finally, for fetal head, a direct least square ellipse fitting method is used to construct a closed head contour, whilst, for fetal femur a closed contour is produced by connecting the detected femur boundaries. The presented method is demonstrated to be promising for clinical applications. Overall the evaluation results of fetal head segmentation and measurement from our method are comparable with the inter-observer difference of experts, with the best average precision of 96.85%, the maximum symmetric contour distance (MSD) of 1.46 mm, average symmetric contour distance (ASD) of 0.53 mm; while for fetal femur, the overall performance of our method is better than the inter-observer difference of experts, with the average precision of 84.37%, MSD of 2.72 mm and ASD of 0.31 mm

Plane Localization in 3-D Fetal Neurosonography for Longitudinal Analysis of the Developing Brain.

The parasagittal (PS) plane is a 2-D diagnostic plane used routinely in cranial ultrasonography of the neonatal brain. This paper develops a novel approach to find the PS plane in a 3-D fetal ultrasound scan to allow image-based biomarkers to be tracked from prebirth through the first weeks of postbirth life. We propose an accurate plane-finding solution based on regression forests (RF). The method initially localizes the fetal brain and its midline automatically. The midline on several axial slices is used to detect the midsagittal plane, which is used as a constraint in the proposed RF framework to detect the PS plane. The proposed learning algorithm guides the RF learning method in a novel way by: 1) using informative voxels and voxel informative strength as a weighting within the training stage objective function, and 2) introducing regularization of the RF by proposing a geometrical feature within the training stage. Results on clinical data indicate that the new automated method is more reproducible than manual plane finding obtained by two clinicians