Abstract
Cerebellum measurements of routinely acquired ultrasound (US) images are commonly used to estimate gestational age and to assess structural abnormalities of the developing central nervous system. Investigating associations between the developing cerebellum and neurodevelopmental outcomes post partum requires standardized cerebellum measurements from large clinical datasets. Such investigations have the potential to identify structural changes that can be used as biomarkers to predict growth and neurodevelopmental outcomes. For this purpose, high throughput, accurate, and unbiased measurements are necessary to replace existing manual, semi-automatic, and automated approaches which are tedious and lack reproducibility and accuracy. In this study, we propose a new deep learning algorithm for automated segmentation of the fetal cerebellum from 2-dimensional (2D) US images. We propose ResU-Net-c a semantic segmentation model optimized for fetal cerebellum structure. We leverage U-Net as a base model with the integration of residual blocks (Res) and introduce dilation convolution in the last two layers to segment the cerebellum (c) from noisy US images. Our experiments used a 5-fold cross-validation with 588 images for training and 146 for testing. Our ResU-Net-c achieved a mean Dice Score Coefficient, Hausdorff Distance, Recall, and Precision of 87.00%, 28.15, 86.00%, and 90.00%, respectively. The superiority of the proposed method over the other U-Net based methods is statistically significant (p <; 0.001). Our proposed method can be leveraged to enable high throughput image analysis in clinical research fetal US images and can be employed in the biometric assessment in fetal US images on a larger scale.
Highlights
Ultrasound (US) imaging is a routinely used modality to monitor fetal growth and development
We present a semantic segmentation technique based on deep convolutional neural network (CNN) for automatic segmentation of the cerebellum in US images
This sort of localization ability can help in better visualization of the fetal brain structures
Summary
Ultrasound (US) imaging is a routinely used modality to monitor fetal growth and development. Measurement of fetal brain structures includes the cerebellum, cerebrum, midbrain, and thalamus on US images, and it forms a part of the fetal anomaly screening performed at 18-21 weeks gestation. The cerebellum is highly conserved in its developmental stages, clearly demarcated from surrounding brain structures and easy to evaluate on routine US images. This makes the cerebellum an important target structure to understand neurodevelopmental outcomes and identify perturbations in the antenatal period that affect its development. Current clinical practices for the measuring of the cerebellum from US images are based on manual or semi-automatic techniques. Manual measurements require free-hand annotation by an experienced clinician, whereas semi-automatic techniques involve user input to fix VOLUME X, 2021
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