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Sahli H, Ben Slama A, Mouelhi A, Soayeh N, Rachdi R, Sayadi M. A computer-aided method based on geometrical texture features for a precocious detection of fetal Hydrocephalus in ultrasound images. Technol Health Care 2021; 28:643-664. [PMID: 32200362 DOI: 10.3233/thc-191752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUD Hydrocephalus is the most common anomaly of the fetal head characterized by an excessive accumulation of fluid in the brain processing. The diagnostic process of fetal heads using traditional evaluation techniques are generally time consuming and error prone. Usually, fetal head size is computed using an ultrasound (US) image around 20-22 weeks, which is the gestational age (GA). Biometrical measurements are extracted and compared with ground truth charts to identify normal or abnormal growth. METHODS In this paper, an attempt has been made to enhance the Hydrocephalus characterization process by extracting other geometrical and textural features to design an efficient recognition system. The superiority of this work consists of the reduced time processing and the complexity of standard automatic approaches for routine examination. This proposed method requires practical insidiousness of the precocious discovery of fetuses' malformation to alert the experts about the existence of abnormal outcome. The first task is devoted to a proposed pre-processing model using a standard filtering and a segmentation scheme using a modified Hough transform (MHT) to detect the region of interest. Indeed, the obtained clinical parameters are presented to the principal component analysis (PCA) model in order to obtain a reduced number of measures which are employed in the classification stage. RESULTS Thanks to the combination of geometrical and statistical features, the classification process provided an important ability and an interesting performance achieving more than 96% of accuracy to detect pathological subjects in premature ages. CONCLUSIONS The experimental results illustrate the success and the accuracy of the proposed classification method for a factual diagnostic of fetal head malformation.
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Affiliation(s)
- Hanene Sahli
- University of Tunis, ENSIT, LR13ES03 SIME, Tunis, Tunisia
| | - Amine Ben Slama
- University of Tunis El Manar, ISTMT, LR13ES07, LRBTM, Tunis, Tunisia
| | - Aymen Mouelhi
- University of Tunis, ENSIT, LR13ES03 SIME, Tunis, Tunisia
| | - Nesrine Soayeh
- Obstetrics, Gynecology and Reproductive Department, Military Hospital, Tunis, Tunisia
| | - Radhouane Rachdi
- Obstetrics, Gynecology and Reproductive Department, Military Hospital, Tunis, Tunisia
| | - Mounir Sayadi
- University of Tunis, ENSIT, LR13ES03 SIME, Tunis, Tunisia
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Brown R, Wijekoon JHB, Fernando A, Johnstone ED, Heazell AEP. Continuous objective recording of fetal heart rate and fetal movements could reliably identify fetal compromise, which could reduce stillbirth rates by facilitating timely management. Med Hypotheses 2014; 83:410-7. [PMID: 25109874 DOI: 10.1016/j.mehy.2014.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/02/2014] [Accepted: 07/11/2014] [Indexed: 11/19/2022]
Abstract
Stillbirth currently affects approximately 1 in every 200 pregnancies in the United Kingdom. Fetuses may exhibit signs of compromise as part of a stress response before stillbirth, including reduced fetal movements (RFM) and fetal heart rate (FHR) alterations. At present, and despite widespread use, current fetal monitoring is not associated with a reduction in perinatal mortality rate (PMR) as signs of fetal compromise are not adequately detected. This may be attributed to inaccuracies resulting from manual interpretation of results or subjective assessment of fetal activity. In addition, signs of compromise often occur only hours or days before fetal death, so may be missed by current monitoring methods, which are performed intermittently. A significant consideration is that correct identification of these signs and consequent intervention can result in the delivery of a healthy baby, thus preventing stillbirth. A hypothesis is presented, proposing prompt detection of fetal compromise with the use of 24-hour continuous objective fetal monitoring. With focus placed on obtaining long-term FHR and fetal movement data, prior interest has been found in developing devices for this purpose. However, introduction into clinical practice has not been achieved. Investigation of the hypothesis will begin with the design of a device to record the mentioned parameters, followed by an appropriate validation process. Should development and testing be successful, an eventual comparison in PMR with the use of continuous fetal monitoring vs current monitoring would address the hypothesis. It is suggested that a timely yet reliable indication of fetal wellbeing obtained via long-term monitoring would allow prompt and appropriate obstetric intervention and consequently reduce PMR.
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Affiliation(s)
- Rebecca Brown
- Maternal and Fetal Health Research Centre, University of Manchester, St. Mary's Hospital, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Jayawan H B Wijekoon
- School of Electrical and Electronic Engineering, University of Manchester, Sackville Street Building, Manchester M13 9PL, United Kingdom
| | - Anura Fernando
- School of Materials, University of Manchester, Oxford Road, M13 9PL, United Kingdom
| | - Edward D Johnstone
- Maternal and Fetal Health Research Centre, University of Manchester, St. Mary's Hospital, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, University of Manchester, St. Mary's Hospital, Oxford Road, Manchester M13 9WL, United Kingdom.
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Rueda S, Fathima S, Knight CL, Yaqub M, Papageorghiou AT, Rahmatullah B, Foi A, Maggioni M, Pepe A, Tohka J, Stebbing RV, McManigle JE, Ciurte A, Bresson X, Cuadra MB, Sun C, Ponomarev GV, Gelfand MS, Kazanov MD, Wang CW, Chen HC, Peng CW, Hung CM, Noble JA. Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge. IEEE TRANSACTIONS ON MEDICAL IMAGING 2014; 33:797-813. [PMID: 23934664 DOI: 10.1109/tmi.2013.2276943] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.
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Yaqub MK, Ioannou C, Javaid MK, Cooper C, Papageorghiou AT, Noble JA. Fusion of 3D ultrasound images of the fetal femur improves boundary definition and volume measurement. Fetal Diagn Ther 2013; 34:158-65. [PMID: 24051348 DOI: 10.1159/000354342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To combine multiple 3D volumes of the same fetal femur into one composite image data set using image registration and wavelet-based fusion. Fused and single data sets were compared in terms of image quality and femur volume (FV) measurement repeatability. METHOD In healthy pregnant volunteers, six volumes of the same femur were acquired and fused into a composite data set. Image quality scores were given to the fused and single data sets by an independent assessor in a blinded fashion; repeatability of FV measurement was assessed using coefficients of variation (CV), intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS Fusion was successful in 24 out of 25 cases. Median image quality score was 7/10 in fused data sets, compared to 6/10 in single data sets (p = 0.096). Repeatability of FV measurement was better in fused data sets (intraobserver CV 4.6% and ICC 0.987; interobserver CV 4.9%, ICC 0.985) compared to single ones (intraobserver CV 5.8%, ICC 0.977; interobserver CV 10.0%, ICC 0.931). The measured FV was significantly higher in fused data sets (mean FV 1.7 vs. 1.3 ml, p < 0.001). CONCLUSION Image registration and wavelet-based fusion can improve image quality and FV repeatability; it also results in an increased FV measurement.
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Affiliation(s)
- Mohammad K Yaqub
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
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Ioannou C, Sarris I, Napolitano R, Ohuma E, Javaid MK, Papageorghiou AT. A longitudinal study of normal fetal femur volume. Prenat Diagn 2013; 33:1088-94. [DOI: 10.1002/pd.4203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 06/22/2013] [Accepted: 07/13/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Christos Ioannou
- Nuffield Department of Obstetrics & Gynaecology; University of Oxford; UK
| | - Ippokratis Sarris
- Nuffield Department of Obstetrics & Gynaecology; University of Oxford; UK
| | | | - Eric Ohuma
- Nuffield Department of Obstetrics & Gynaecology; University of Oxford; UK
| | - M. Kassim Javaid
- Oxford NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; University of Oxford; UK
| | - Aris T. Papageorghiou
- Nuffield Department of Obstetrics & Gynaecology; University of Oxford; UK
- Oxford Maternal and Perinatal Health Institute, Green Templeton College; University of Oxford; UK
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Ioannou C, Javaid MK, Mahon P, Yaqub MK, Harvey NC, Godfrey KM, Noble JA, Cooper C, Papageorghiou AT. The effect of maternal vitamin D concentration on fetal bone. J Clin Endocrinol Metab 2012; 97:E2070-7. [PMID: 22990090 PMCID: PMC3485609 DOI: 10.1210/jc.2012-2538] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Vitamin D deficiency during pregnancy may be associated with suboptimal fetal growth, but direct evidence is lacking. OBJECTIVES The aim of the study was to validate a method for fetal femur volume (FV) measurement using three-dimensional ultrasound and to detect correlations between FV and maternal vitamin D concentration. DESIGN, SETTING, AND PARTICIPANTS A novel method for assessing FV consists of three ultrasound measurements-femur length, proximal metaphyseal diameter (PMD), and midshaft diameter-and a volume equation; this was validated by comparing ultrasound to computed tomography measurements in six pregnancies after mid-trimester termination. This method was then applied in a cohort of healthy pregnant women participating in the Southampton Women Survey. Fetal three-dimensional ultrasound and maternal 25-hydroxyvitamin D [25(OH)D] levels were performed at 34 wk; dual-energy x-ray absorptiometry of the newborn was performed shortly after birth. Univariate and multiple linear regression analyses were performed between maternal characteristics and fetal outcomes. MAIN OUTCOME MEASURES We performed ultrasound measurements of the fetal femur. RESULTS In 357 pregnant participants, serum 25(OH)D correlated significantly with FV (P = 0.006; r = 0.147) and PMD (P = 0.001; r = 0.176); FV also demonstrated positive univariate correlations with maternal height (P < 0.001; r = 0.246), weight (P = 0.003; r = 0.160), triceps skinfold thickness (P = 0.013; r = 0.134), and a borderline negative effect from smoking (P = 0.061). On multiple regression, independent predictors of FV were the maternal height and triceps skinfold thickness; the effect of 25(OH)D on FV was attenuated, but it remained significant for PMD. CONCLUSION Using a novel method for assessing FV, independent predictors of femoral size were maternal height, adiposity, and serum vitamin D. Future trials should establish whether pregnancy supplementation with vitamin D is beneficial for the fetal skeleton, using FV and PMD as fetal outcome measures.
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Affiliation(s)
- C Ioannou
- Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
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Lee IW, Chang CH, Cheng YC, Ko HC, Chang FM. A Review of Three-dimensional Ultrasound Applications in Fetal Growth Restriction. J Med Ultrasound 2012. [DOI: 10.1016/j.jmu.2012.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Elia M, Stratton RJ. An analytic appraisal of nutrition screening tools supported by original data with particular reference to age. Nutrition 2012; 28:477-94. [DOI: 10.1016/j.nut.2011.11.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 11/07/2011] [Indexed: 12/22/2022]
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Discordant twins: diagnosis, evaluation and management. Am J Obstet Gynecol 2012; 206:10-20. [PMID: 21864822 DOI: 10.1016/j.ajog.2011.06.075] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 06/15/2011] [Accepted: 06/21/2011] [Indexed: 11/21/2022]
Abstract
Approximately 16% of twin gestations have discordance of at least 20%. We identified 14 risk factors for divergent growth that can be categorized as maternal, fetal, or placental. Determination of chorionicity and serial ultrasound evaluation with a high index of suspicion for divergent growth is required for the diagnosis and stratification of risk. The highest reported likelihood ratio for detection of discordance was 5.9 during the first trimester examination and 6.0 for the second trimester. Although our ability to identify discordant twins is limited, once suspected and at viable gestational age, these pregnancies should have antepartum testing. Discordant growth alone is not an indication for preterm birth. Although there are multiple publications on the increased morbidity and mortality rates with discordant growth, there is a paucity of reports on how to manage them optimally and deliver them in a timely manner.
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Ioannou C, Sarris I, Salomon LJ, Papageorghiou AT. A review of fetal volumetry: the need for standardization and definitions in measurement methodology. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 38:613-619. [PMID: 21674657 DOI: 10.1002/uog.9074] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2011] [Indexed: 05/30/2023]
Abstract
Volume charts of fetal organs and structures vary considerably among studies. This review identified 42 studies reporting normal volumes, namely for fetal brain (n = 3), cerebellum (n = 4), liver (n = 6), femur (n = 2), lungs (n = 15), kidneys (n = 3) and first-trimester embryo (n = 9). The differences among median volumes were expressed both in percentage form and as standard deviation scores. Wide discrepancies in reported normal volumes make it extremely difficult to diagnose pathological organ growth reliably. Given its magnitude, this variation is likely to be due to inconsistencies in volumetric methodology, rather than population differences. Complicating factors include the absence of clearly defined anatomical landmarks for measurement; inadequate assessment and reporting of method repeatability; the inherent difficulty in validating fetal measurements in vivo against a reference standard; and a multitude of mutually incompatible three-dimensional (3D) imaging formats and software measuring tools. An attempt to standardize these factors would improve intra- and inter-researcher agreement concerning reported volumetric measures, would allow generalization of reference data across different populations and different ultrasound systems, and would allow quality assurance in 3D fetal biometry. Failure to ensure a quality control process may hamper the wide use of 3D ultrasound.
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Affiliation(s)
- C Ioannou
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
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Chang CH, Tsai PY, Yu CH, Ko HC, Chang FM. Soft tissue volume of upper arm in predicting small-for-gestational-age fetuses using three-dimensional ultrasound. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:21-26. [PMID: 20949572 DOI: 10.1002/jcu.20748] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To assess the value of fetal soft tissue volume (STV) of the upper arm in predicting small-for-gestational-age (SGA) fetuses using three-dimensional (3D) ultrasound (US). METHODS We used 3D US to test the accuracy of fetal STV of the upper arm measurement in predicting SGA in a prospective cross-sectional study. RESULTS Fetal STV of the upper arm assessed by 3D US can differentiate SGA fetuses from appropriate-for-gestational-age (AGA) fetuses. Using the 5th percentile as the cutoff, the sensitivity of fetal upper arm STV in predicting SGA fetuses was 84.1%, specificity, 93.4%, positive predictive value, 71.1%, negative predictive value, 96.8%, and overall accuracy, 91.9%. In addition, the diagnostic accuracy of fetal arm STV was better than that of the biparietal diameter, abdominal circumference, and femur length. CONCLUSION Fetal STV of upper arm assessment by 3D US is a novel method to predict SGA fetuses.
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Affiliation(s)
- Chiung-Hsin Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical Center, Tainan, Taiwan
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Yagel S, Cohen SM, Messing B, Valsky DV. Three-dimensional and four-dimensional ultrasound applications in fetal medicine. Curr Opin Obstet Gynecol 2009; 21:167-74. [DOI: 10.1097/gco.0b013e328329243c] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chang CH, Tsai PY, Yu CH, Ko HC, Chang FM. Predicting fetal growth restriction with renal volume using 3-D ultrasound: efficacy evaluation. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:533-537. [PMID: 18055097 DOI: 10.1016/j.ultrasmedbio.2007.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 09/30/2007] [Accepted: 10/11/2007] [Indexed: 05/25/2023]
Abstract
Early detection and management of fetal growth restriction (FGR) is very important in prenatal care and daily practice, because FGR fetuses may suffer increased risk of perinatal morbidity and mortality. Renal volume (RV) might be one of the important parameters of fetal growth. Yet, no prenatal assessment of fetal RV in FGR fetuses by 3-D ultrasound (US) has been reported. We undertook a prospective and cross-sectional study using quantitative 3-D US to assess the efficacy of fetal RV in predicting FGR. All fetuses were singletons and were followed-up to delivery to determine whether they had FGR complications. In total, 221 fetuses without FGR and 28 fetuses with FGR were included. Our results showed fetal RV assessed by 3-D US can differentiate fetuses with FGR from fetuses without FGR. The best predicting threshold for FGR is at the tenth percentile of fetal RV. Using the tenth percentile as the cutoff, the efficacy of fetal RV in predicting FGR was sensitivity 96.4%, specificity 95.9%, positive predictive value 75.0%, negative predictive value 99.5% and accuracy 96.0%, respectively. Fetal RV assessed by 3-D US can be applied to detect FGR prenatally. We believe fetal RV assessment using 3-D US is a useful test in detecting fetuses with FGR.
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Affiliation(s)
- Chiung-Hsin Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan
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