Abstract
An automatic method able to recognize a presented section through the biparietal plane of the fetal head and a section through the fetal femur in ultrasound images is developed. Once the correct anatomical section for measurement is identified by the machine, the placement of the measurement calipers is automatically determined by fitting an active contour model to the structure of interest. The fetal biparietal diameter (BPD) and femur length (FL) are then measured automatically. The validation data set contained 167 and 197 B-mode images for BPD and FL measurements, respectively. The images were acquired using 4 different ultrasound scanners, which resulted in varied image quality and gain settings. The mean gestational age (GA) of the fetuses was 19.4 weeks, range 16 to 41 weeks. A measurement success rate of 90% was achieved for both BPD and FL. The correlation coefficients between the manual and automatic measurements were 0.995 (BPD) and 0.967 (FL), mean errors were 0.5 mm (BPD) and -1.7 mm (FL) and error range with 95% confidence interval (CI) were ﹣3.8 - 4.8 mm (BPD) and ﹣11.4 - 8.1 mm (FL). The automatic measurement results were consistent in both high and low gain settings. The intraclass correlation coefficients between manual and automatic measurements were 0.995 (95% CI; 0.981 - 0.999) for BPD in high gain, 1.0 (95% CI; 0.998 - 1.0) for BPD in low gain, 0.998 (95% CI; 0.991 - 0.999) for FL in high gain and 0.999 (95% CI; 0.996 - 1.0) for FL in low gain settings. The method was implemented on a prototype, portable ultrasound machine designed to be used in low- and middle-income countries (LMIC). The overall performance of the method supports our hypothesis that automated methods can be used and are beneficial in a clinical setting.
Highlights
Ultrasound scanning in pregnancy has become the standard for care in the high income countries (HIC) [1]
The method was implemented on a prototype, portable ultrasound machine designed to be used in low- and middle-income countries (LMIC)
The automatically measured biparietal diameter (BPD) and femur length (FL) values were comparable to the manual measurements
Summary
Ultrasound scanning in pregnancy has become the standard for care in the high income countries (HIC) [1]. It is currently offered at week 12 or around week 18, or both. The benefit of using ultrasound to improve pregnancy care is important in low- and middle-income countries (LMIC) as in the HIC. Due to varying sources of current, large variations in temperature and humidity, transport, shock and vibration, and dusty environments, essential parts break and cannot be replaced or repaired. Another major problem is the high cost of ultrasound machines. In the rural areas of LMIC, there is a lack of technical knowledge for operating ultrasound machines
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