Abstract

In this paper we present a computer aided detection (CAD) system for automated measurement of the fetal head circumference (HC) in 2D ultrasound images for all trimesters of the pregnancy. The HC can be used to estimate the gestational age and monitor growth of the fetus. Automated HC assessment could be valuable in developing countries, where there is a severe shortage of trained sonographers. The CAD system consists of two steps: First, Haar-like features were computed from the ultrasound images to train a random forest classifier to locate the fetal skull. Secondly, the HC was extracted using Hough transform, dynamic programming and an ellipse fit. The CAD system was trained on 999 images and validated on an independent test set of 335 images from all trimesters. The test set was manually annotated by an experienced sonographer and a medical researcher. The reference gestational age (GA) was estimated using the crown-rump length measurement (CRL). The mean difference between the reference GA and the GA estimated by the experienced sonographer was 0.8 ± 2.6, −0.0 ± 4.6 and 1.9 ± 11.0 days for the first, second and third trimester, respectively. The mean difference between the reference GA and the GA estimated by the medical researcher was 1.6 ± 2.7, 2.0 ± 4.8 and 3.9 ± 13.7 days. The mean difference between the reference GA and the GA estimated by the CAD system was 0.6 ± 4.3, 0.4 ± 4.7 and 2.5 ± 12.4 days. The results show that the CAD system performs comparable to an experienced sonographer. The presented system shows similar or superior results compared to systems published in literature. This is the first automated system for HC assessment evaluated on a large test set which contained data of all trimesters of the pregnancy.

Highlights

  • Ultrasound imaging is widely used for screening and monitoring of pregnant women, since it is a low-cost, real-time and non-invasive imaging method

  • We focus on measuring the head circumference (HC) because this measurement can be used to determine the gestational age (GA) and monitor growth of the fetus

  • The primary reason for this results from the fact that the natural variation in fetal size increases with GA

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Summary

Methods

A total of 1334 two-dimensional (2D) ultrasound images of the HC were collected from the database of the Department of Obstetrics of the Radboud University Medical Center, Nijmegen, the Netherlands. The ultrasound images were acquired from 551 pregnant women who received a routine ultrasound screening exam between May 2014 and May 2015. Fetuses that did not exhibit any growth abnormalities were included in this study. Images were acquired by experienced sonographers using either the Voluson E8 or the Voluson 730 ultrasound device (General Electric, Austria). The local ethics committee (CMO Arnhem-Nijmegen) approved the collection and use of this data for this study. Due to the retrospective data collection, informed consent was waived. All data was anonymized according to the tenets of the Declaration of Helsinki

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