Spatiotemporal Image Correlation Research Articles

Comparison of Different Ultrasonic Screening Methods and Analysis of High Risk Factors for Fetal Cardiac Malformation in Second Trimester of Pregnancy.

Current study aims to compare the application of two-dimensional (2D) color doppler ultrasound (CDU) and four-dimensional (4D) ultrasound spatiotemporal image correlation (STIC) in fetal congenital heart disease in the second trimester of pregnancy and to analyze the high risk factors of the disease. From August 2019 to July 2021, 135 second-trimester patients with highly suspected congenital heart malformations were selected who underwent prenatal screening at South Taihu Hospital Affiliated to Huzhou University. 2D-CDU, 4D STIC, and postnatal examination were completed in all patients. 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were used to detect fetal cardiac malformations and classify cardiac malformations. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were compared. The results of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC screening were analyzed for consistency using the results of postpartum diagnosis as the gold standard. Moreover, effects of maternal gestational factors on fetal cardiac malformations by univariate and multivariate analysis. 2D-CDU combined with 4D STIC showed significantly higher section display number than 2D-CDU or 4D STIC in the view of ductal arch, aortic arch, and aortic short-axis. A total of 45 cases of fetal congenital heart malformation were detected in 135 patients in the second trimester, 40, 38 or 42 cases were detected by 2D-CDU, 4D STIC or 2D-CDU combined with 4D STIC, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU combined with 4D ultrasound in congenital heart malformation screening were higher than those of 2D-CDU or 4D STIC. Kappa agreement analysis showed that the diagnostic results of 4D STIC and 2D-CDU combined with 4D ultrasound in fetuses with suspected congenital heart malformation were in excellent agreement (κ > 0.75), while 2D-CDU was in good agreement with postpartum diagnosis (κ < 0.75). Univariate and multivariate regression analysis revealed that maternal age ≥ 35, drinking during pregnancy, and history of adverse pregnancy and childbirth were all independent risk factors for fetal cardiac malformations, while folic acid supplementation was an independent protective factor for fetal cardiac malformations. 2D-CDU combined with 4D echocardiography may be superior to single 2D-CDU or 4D STIC in the screening of fetal congenital heart malformation in the second trimester. In order to reduce the incidence of fetal heart anomalies, we should strengthen the screening of pregnancy anomalies in high-risk pregnant women and control the risk factors.

Evaluating fetal tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) using spatiotemporal image correlation (STIC) M-mode.

This study aimed to evaluate the feasibility andreliability of tricuspid and mitral annular plane systolic excursion measurements (TAPSE and MAPSE) applying M-mode Spatiotemporal Image Correlation (STIC) technology in low-risk pregnancies. An initial retrospective pilot study was carried out to assess repeatability, followed by a larger mixed cross-sectional and prospective longitudinal study, both evaluating low-risk singleton pregnancies between 22+6 and 39+1 weeks. As only annuli capture was necessary, STIC acquisition parameters were set to the minimum volume angle of 15° and acquisition time of 7.5 s. A total of 330 volumes were analysed offline applying STIC M-mode. Acquisition rates were 96.9 % for TAPSE and 93.7 % MAPSE in the pilot study (n=32) and 98.0 % for both in the longitudinal study (n=102). Both study designsrevealed good repeatability for both sides of the heart, withhigher intraclass correlation coefficients (ICCs) for TAPSE (0.84-0.94) compared to MAPSE (0.80-0.88). Goodrepeatability was demonstrated for both sides of the heart, more so for TAPSE than MAPSE, with ICCs for TAPSE 0.84-0.91 and MAPSE 0.75-0.76, comparable to prior ICCs forSTIC repeatability. Modified STIC acquisition settings specifically tailored for capturing the longitudinal annular displacement may improve STIC TAPSE and MAPSE acquisition rates, optimising image quality for precise measurement and potentially bringing these modalities closer to clinical application.

B-flow/spatiotemporal image correlation M-mode ultrasound provides novel method to quantify spiral artery remodeling during normal human pregnancy.

During human pregnancy placental extravillous trophoblasts replace the vascular smooth muscle and elastic tissue within the walls of the uterine spiral arteries, thereby remodeling these arteries into distensible low resistance vessels to promote placental perfusion. The present study, determined whether B-flow/ spatio-temporal image correlation (STIC) M-mode ultrasonography provides an in vivo imaging method to digitally quantify spiral artery luminal distensibility, as a physiological index of spiral artery remodeling, during advancing stages of normal human pregnancy. A prospective longitudinal observational study was conducted to quantify spiral artery distensibility, i.e. vessel luminal diameter at systole minus diameter at diastole, by B-flow/STIC M-mode ultrasonography during the first, second and third trimesters in 290 women exhibiting normal pregnancy. Maternal serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase (sFlt-1), growth factors that modulate events important in spiral artery remodeling, were quantified in a subset of the subjects at the first, second and third semesters. Median [first quartile, third quartile] spiral artery distensibility progressively increased (P < 0.0001) between the first trimester (0.17 [0.14, 0.21]), second (0.23 [0.18, 0.28]) and third (0.26 [0.21, 0.35]) trimesters of pregnancy. Spiral artery volume flow (ml/cardiac cycle) progressively increased (P < 0.001) between the first 2.49 [1.38, 4.99], second 3.86 [2.06, 6.91] and third 7.79 [3.83, 14.98] trimesters. Coinciding with the elevation in spiral artery distensibility, the median ratio of serum PlGF/sFlt-1 levels increased (P < 0.001) between the first (7.2 [4.5, 10], second (22.7 [18.6, 42.2]) and third (56.2 [41.9, 92.5] trimesters. The present study shows that B-flow/STIC M-mode ultrasonography provides an in vivo imaging technology to digitally quantify structural/physiological expansion of the walls of the spiral arteries during the cardiac cycle as a consequence of their transformation into compliant vessels during advancing stages of normal human pregnancy. This article is protected by copyright. All rights reserved.

GAN-argcPredNet v2.0: a radar echo extrapolation model based on spatiotemporal process enhancement

Abstract. Precipitation nowcasting has important implications for urban operation and flood prevention. Radar echo extrapolation is a common method in precipitation nowcasting. Using deep learning models to extrapolate radar echo data has great potential. The increase of lead time leads to a weaker correlation between the real rainfall evolution and the generated images. The evolution information is easily lost during extrapolation, which is reflected as echo attenuation. Existing models, including generative adversarial network (GAN)-based models, have difficulty curbing attenuation, resulting in insufficient accuracy in rainfall prediction. To solve this issue, a spatiotemporal process enhancement network (GAN-argcPredNet v2.0) based on GAN-argcPredNet v1.0 has been designed. GAN-argcPredNet v2.0 curbs attenuation by avoiding blurring or maintaining the intensity. A spatiotemporal image correlation (STIC) prediction network is designed as the generator. By suppressing the blurring effect of rain distribution and reducing the negative bias by STIC attention, the generator generates more accurate images. Furthermore, the discriminator is a channel–spatial (CS) convolution network. The discriminator enhances the discrimination of echo information and provides better guidance to the generator in image generation by CS attention. The experiments are based on the radar dataset of southern China. The results show that GAN-argcPredNet v2.0 performs better than other models. In heavy rainfall prediction, compared with the baseline, the probability of detection (POD), the critical success index (CSI), the Heidke skill score (HSS) and bias score increase by 18.8 %, 17.0 %, 17.2 % and 26.3 %, respectively. The false alarm ratio (FAR) decreases by 3.0 %.

Does matrix transducer technology improve quality and repeatability of four-dimensional tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements?

Novel ultrasound technology and software processing allow offline evaluation of tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements. We wished to compare both novel 4D matrix (eM6C) and conventional (RAB6-D) transducers with variable settings (electronic spatiotemporal image correlation, spatiotemporal image correlation and four-dimensional real time) to determine if there was a significant difference in absolute value, quality and repeatability of the resultant reconstructed image and M-mode trace. A blinded prospective cross-sectional study of normal fetuses from 23 to 38 weeks' gestation were recruited. After routine sonography, four-dimensional volumes were stored and analysed using GE 4DView™ software. Statistical analysis explored variability, correlations and repeatability of the measurements with chi-square analysis, intraclass correlations and the Bland-Altman comparison plots. A scoring system was devised for image quality. Eighteen participants generated 282 data volumes. Absolute values demonstrated some inconsistencies for both tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements with variations between transducers: the highest for the RAB6-D/spatiotemporal image correlation setting and the lowest for the four-dimensional real-time settings. The RAB6-D/spatiotemporal image correlation setting was the most repeatable combination (intraclass correlation coefficient = 0.85). Poorest image quality (M-mode trace, four-chamber view, annuli) came from the RAB6-D/four-dimensional real-time combination with the eM6C/electronic spatiotemporal image correlation and RAB6-D/spatiotemporal image correlation settings being nearly identical. We show that transducer and setting combinations influence absolute tricuspid annular plane systolic excursion/mitral annular plane systolic excursion measurements, so need to be articulated in future research. The transducer setting (electronic spatiotemporal image correlation/spatiotemporal image correlation/four-dimensional real time) was a more significant factor than the type of transducer (conventional vs matrix). Subjective image evaluation does not correlate well with repeatability of image acquisition. Further studies are needed to compare measurements using four-dimensional post-processing tools against conventional real-time measurements.

Evaluation of cardiac contractility of fetuses from pregestational diabetes mellitus pregnancies by three-dimensional ultrasound.

This study aimed to evaluate cardiac contractility in fetuses from pregestational diabetes mellitus pregnancies by three-dimensional ultrasound using spatiotemporal image correlation in rendering mode. A retrospective cross-sectional study was performed on 40 fetuses from nondiabetic pregnancies and 28 pregestational diabetic pregnancies between 20 and 33 weeks and 6 days. Cardiac contractility was assessed by measuring the ventricular myocardial area in diastole subtracted from the ventricular myocardial area in systole. Pregestational diabetic pregnancies had a lower maternal age than nondiabetic pregnancies (26.7 vs. 39.9 years, p=0.019). Cardiaccontractility in fetuses from diabetic and nondiabetic pregnancies was similar (p=0.293). A moderately positive and significant correlation was observed between gestational age and cardiac contractility (r=0.46, p=0.0004). A 1-week increase in gestational age was responsible for a 0.1386 cm2 increase in cardiac contractility. Cardiac contractility as evaluated by three-dimensional ultrasound using spatiotemporal image correlation in rendering mode showed no significant differences across fetuses with and without pregestational diabetes.

Spatio-Temporal Image Correlation: Three-Dimensional Imaging for Fetal Cardiac Screening and Congenital Heart Disease Assessment.

Spatio-Temporal Image Correlation: Three-Dimensional Imaging for Fetal Cardiac Screening and Congenital Heart Disease Assessment.

Kleefstra syndrome presenting as pulmonary atresia with intact ventricular septum diagnosed prenatally at 16 weeks using four-dimensional spatiotemporal image correlation.

Kleefstra syndrome presenting as pulmonary atresia with intact ventricular septum diagnosed prenatally at 16 weeks using four-dimensional spatiotemporal image correlation.

Semi-Automatic Measurement of Fetal Cardiac Axis in Fetuses with Congenital Heart Disease (CHD) with Fetal Intelligent Navigation Echocardiography (FINE).

Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract reference planes and cardiac axis from cardiac spatiotemporal image correlation (STIC) volume datasets. This study analyses the cardiac axis in fetuses affected by CHD/thoracic masses (n = 545) compared to healthy fetuses (n = 1543) generated by FINE. After marking seven anatomical structures, the FINE software generated semi-automatically nine echocardiography standard planes and calculated the cardiac axis. Our study reveals that depending on the type of CHD, the cardiac axis varies. In approximately 86% (471 of 542 volumes) of our pathological cases, an abnormal cardiac axis (normal median = 40-45°) was detectable. Significant differences between the fetal axis of the normal heart versus CHD were detected in HLHS, pulmonary atresia, TOF (p-value < 0.0001), RAA, situs ambiguus (p-value = 0.0001-0.001) and absent pulmonary valve syndrome, DORV, thoracic masses (p-value = 0.001-0.01). This analysis confirms that in fetuses with CHD, the cardiac axis can significantly deviate from the normal range. FINE appears to be a valuable tool to identify cardiac defects.

Demonstration of Double Aortic Arch in a 21 Weeks Primigravida by Color Spatiotemporal Image Correlation Rendering Technique

AbstractFetal double aortic arch (DAA) is a rare congenital arch anomaly characterized by the presence of two aortic arches instead of the normal single arch. DAA is an uncommon finding during routine fetal echocardiography.Prenatal ultrasound detection of fetal DAA is crucial for early identification and appropriate management of affected fetuses. Despite the challenges and limitations, advancements in imaging technology and expertise have improved diagnostic accuracy.Four-dimensional (4D) ultrasound provides a volumetric representation of the fetal structures. It allows for better visualization and assessment of complex anatomical abnormalities, including DAA. With 4D imaging, the sonographer can manipulate the image, rotate it, and view it from different angles, aiding in the identification of the double arch anomalyThis is a case of double aortic arch diagnosed with the spatiotemporal image correlation (STIC) technique of 4D ultrasound using color Doppler.

The Construction of an Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease: Xinhua Hospital Model

With the growing influence of slow population growth and population aging, China has established the birth policy and issued a series of documents to promote maternal and fetal health and improve the birth rate. With the increase in prevalence of birth defects, timely diagnosis and intervention in utero provide possibilities to reduce unnecessary abortions and offer better prognosis. Congenital heart disease (CHD), as one of the most common congenital birth defects, is the leading cause of mortality in patients aged &lt;5 years, and brings a heavy burden to both the affected families and society. Fetuses with CHD are associated with an increased risk of pregnancy-related complications and premature birth, and children with CHD typically face growth and developmental problems even after the correction of malformation. Therefore, management including diagnosis, treatment, and rehabilitation throughout the fetal period into childhood and even adulthood is essential for children with CHD. Based on the rapid advances in intrauterine and perinatal medicine and an in-depth collaboration among obstetrics and pediatrics, a novel diagnosis and treatment system has been established for the management of CHD in the past 2 decades in Shanghai Xinhua Hospital. This Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease model provides prenatal diagnosis, intrauterine intervention, delivery room service and neonatal therapies, and postintrauterine rehabilitation for children with CHD. We have developed a four-dimensional spatiotemporal image correlation echocardiography and a three-dimensional cardiac virtual endoscopy system for the intrauterine diagnosis of CHD, dramatically raising the diagnostic utility. Our innovative and independent newborn-intervention technique has effectively reduced the re-intervention rate in patients with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis. In 2018, Xinhua Hospital independently performed the case of fetal aortic valvuloplasty in Asia through a multidepartment collaborative effort. All children treated in this system achieved biventricular circulation and a better long-term postoperative outcome. We also have conducted postoperative rehabilitation therapy to promote the development and health of children with CHD. The practice of Xinhua model has reduced unnecessary abortion of CHD fetuses, reduced the mortality rate associated with critical CHD, and improved the mid- and long-term prognosis in CHD, which is essential to promote the fertility level and children’s health. Furthermore, translational medicine platform and the birth cohort Early Life Plan was constructed to explore the origins of major developmental diseases and establish an early intervention model in CHD. This practice of assessment of the intrauterine system has been expanded to other congenital defects in Xinhua Hospital, and sequential treatment of more than 2,000 cases has been completed to date. Based on practice in intrauterine management of CHD and other diseases, the concept of Intrauterine Pediatrics was proposed as a first to emphasize early prevention and intervention of childhood diseases and promote a comprehensive lifecycle service for children. The development and evolution of this system requires further attention not only from researchers but also from the government and global medical communities.

The prenatal diagnosis and prognosis of fetal right aortic arch and double aortic arch malformation: A single-center study.

This study aimed to characterize the pathological types, diagnosis, chromosomal abnormalities, and postnatal clinical manifestations of right and double aortic arch malformations in fetuses. In this retrospective study, all fetuses diagnosed with right or double aortic arch anomalies for whom conventional two-dimensional echocardiography combined with spatio-temporal image correlation was performed at our tertiary referral center between December 2012 and December 2021 were included. In total, 234 fetuses with aortic arch abnormalities were identified. Forty-one cases lost to follow-up. One hundred ninety-three cases were included in this study. One hundred eighty-seven cases with right aortic arch. Six cases with double aortic arch. Most cases of right aortic arch with aberrant left subclavian artery (77/101, 76.2%) were isolated lesions, whereas most of those with mirror-image branching (45/75, 60%) were associated with intracardiac or extracardiac anomalies. Chromosomal abnormalities were screened prenatally in 113 fetuses with right aortic arch, among whom three with aberrant left subclavian artery (3/63, 4.8%) and eight with mirror-image branching (8/50, 16%) had chromosome anomalies (p < 0.05). Furthermore, three cases had microdeletion 22q11.2 and these were significantly associated with intracardiac malformations. Most cases of isolated right aortic arch do not present with clinical symptoms except isolated left subclavian artery and isolated left brachiocephalic trunk. In addition, the risk of chromosomal abnormalities in patients with isolated right aortic arch is very low. We recommend that pregnant women should be informed of the risks and benefits of undergoing invasive prenatal chromosomal detection.

Prenatal diagnosis, 4D spatiotemporal image correlation imaging, pregnancy, and postnatal outcome of partial Uhl's anomaly.

Journal Article Accepted manuscript Prenatal diagnosis, 4D spatiotemporal image correlation imaging, pregnancy, and postnatal outcome of partial Uhl’s anomaly Get access Balaganesh Karmegaraj, DM Balaganesh Karmegaraj, DM Sowmi Fetal heart centre, Tirunelveli, Tamilnadu and Fetal cardiology Division, Department of Paediatric Cardiology, Amrita institute of Medical Sciences and research centre, Kochi, Kerala, India Address for correspondence: Dr Balaganesh Karmegaraj MD., DM, Clinical Assistant Professor, Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, AIMS Ponekkara PO, Kochi, Kerala, India Pin: 682 041, Tel: +91 484 285 3570 , Fax. +91 484 2802020, Mobile: +9197461 31803. Email: pedsheartkbg@gmail.com https://orcid.org/0000-0001-8728-2140 Search for other works by this author on: Oxford Academic PubMed Google Scholar European Heart Journal - Cardiovascular Imaging, jead133, https://doi.org/10.1093/ehjci/jead133 Published: 07 June 2023 Article history Received: 06 May 2023 Editorial decision: 04 June 2023 Accepted: 06 June 2023 Published: 07 June 2023

Incidence of Fetal Myocardial Hypertrophy in Mother with Diabetes Mellitus by Using Cardio-Spatiotemporal Image Correlation (STIC) M-Mode.

The aim was to demonstrate the prevalence of fetal myocardial hypertrophy (FMH) in diabetes mellitus (DM) pregnant women using spatio-temporal image correlation (STIC) M-mode. This prospective descriptive study was conducted at Bhumibol Adulyadej Hospital (BAH) Royal Thai Air Force between April and December 2022. Participants were singleton DM pregnant women with gestational age (GA) between 18 and 40 weeks who had antenatal care and delivery at BAH. DM screening was randomized blood sugar obtained from all participants. All participants underwent fetal heart exams by four-dimension ultrasound with STIC M-mode. One hundred and forty-five participants were recruited and classified as pregestational (PDM) and gestational DM (GDM) at 31 and 114 cases, respectively. The mean age of participants was 31.7 years old. Fasting blood sugar (FBS) of PDM was significantly higher than GDM (105.1 vs 87.0 mg%). GDMA2 had more elevated FBS than GDMA1 (p < 0.001). PDM had significantly greater FBS and two-hour postprandial blood sugar (2hr-PP) than GDM (105.1/87.0 and 151.5/117.9 mg%, respectively). FBS and 2hr-PP of GDMA2 were more than GDMA1 with statistical significance. Good glycemic control of GDM was significantly better than PDM. GDMA1 had better glycemic control than GDMA2 with statistical significance. Four-fifth (115/145) of participants had FMH. FMH and estimated fetal weight among PDM and GDM were comparable. Both good and poor glycemic control had similar FMH. Neonatal outcomes of FMH or non-FMH infants were similar. The prevalence of FMH in diabetic pregnant women was 79.3%. Glycemic control had no correlation to FMH.

Application of Semiautomatic Fetal Intelligent Navigation Echocardiography (FINE) in Twin Pregnancies: Half the Work or Twice the Effort?

To assess the performance of fetal intelligent navigation echocardiography (FINE, 5D Heart™) for automated volumetric investigation of the fetal heart in twin pregnancies. Three hundred twenty-eight twin fetuses underwent fetal echocardiography in the second and third trimesters. Spatiotemporal image correlation (STIC) volumes were obtained for a volumetric investigation. The volumes were analyzed using the FINE software, and the data were investigated regarding image quality and many properly reconstructed planes. Three hundred and eight volumes underwent final analysis. 55.8% of the included pregnancies were dichorionic twin pregnancies, and 44.2% were monochorionic twin pregnancies. The mean gestational age (GA) was 22.1 weeks, and the mean maternal BMI was 27.3 kg/m2. The STIC-volume acquisition was successful in 100.0% and 95.5% of cases. The overall depiction rates of FINE were 96.5% (twin 1) and 94.7% (twin 2), respectively (p = 0.0849, not significant). In 95.9% (twin 1) and 93.9% (twin 2), at least 7 planes were reconstructed properly (p = 0.6056, not significant). Our results indicate that the FINE technique used in twin pregnancies is reliable. No significant difference between the depiction rates of twin 1 and twin 2 could be detected. In addition, the depiction rates are as high as those derived from singleton pregnancies. Due to the challenges of fetal echocardiography in twin pregnancies (i.e., greater rates of cardiac anomaly and more difficult scans), the FINE technique might be a valuable tool to improve the quality of medical care in those pregnancies.

Prenatal diagnosis of fetal conotruncal defects by using 2D ultrasound and HD live flow combined with spatiotemporal image correlation.

To explore the diagnostic value of spatiotemporal image correlation (STIC) for different types of fetal conotruncal defects (CTDs). The clinical data and STIC images of 174 fetuses with CTDs diagnosed via prenatal ultrasound were analyzed retrospectively. Among the 174 cases of CTDs, 58 were tetralogy of Fallot (TOF); 30, transposition of great arteries (TGA) (D-TGA, 23 cases; cc-TGA, 7 cases); 26, double outlet of the right ventricle (DORV); 32, persistent arterial trunk (PTA) (type A1, 15 cases; type A2, 11 cases; type A3, 5 cases; type A4, 1 case); and 28, pulmonary atresia (PA) (ventricular septal defect, 24 cases; ventricular septal integrity, 4 cases). Among the cases, 156 were complicated with complex congenital intracardiac and extracardiac malformations. The abnormal display rate of the four-chamber view of two-dimensional echocardiography was low. The display rate of the permanent arterial trunk was the highest (90.6%) in STIC imaging. STIC imaging can be used in the diagnosis of different types of CTDs, especially in persistent arterial trunks, and thus has great value for the clinical treatment and prognosis of these defects.

Application of Color Doppler with 3- and 4-Dimensional Ultrasonography in the Prenatal Evaluation of Fetal Extracardiac and Placental Abnormalities

Using color Doppler flow imaging or high-definition flow imaging with three-dimensional volume or spatio-temporal image correlation (STIC) in the glass-body mode allows displaying both gray-scale and color information of the heart cycle-related flow events and vessel spatial relationship. Conventionally, STIC in the glass-body mode has been used to examine the fetal heart and assess heart defects. Recently, a novel application of STIC in the visualization of abdominal precordial veins and intraplacental vascularization in singleton pregnancies has been reported. The aim of this present review is to discuss the use of color Doppler with three- and four-dimensional ultrasonography in the evaluation of extracardiac, placental, umbilical cord and twin abnormalities with examples. The glass-body mode is complementary to conventional 2D ultrasonography. Further studies are required to investigate use of the glass-body mode in the assessment of intraplacental vascularization in singleton and twin pregnancies.

Advances in Maternal–Fetal Imaging

Advances in Maternal–Fetal Imaging

Image correlation spectroscopy approaches to probe diffusion in cell.

Among the methods for studying molecular dynamics through fluorescence, fluorescence correlation spectroscopy (FCS) is one of the most effective in vivo experimental techniques. It returns information about the diffusion of fluorescent molecule pools in a single well-defined small volume by means of auto/cross-correlating fluorescence intensity fluctuation. Since probing a single point may not be representative of a complex landscape, we can use the spatio-temporal image correlation spectroscopy (stICS) method. Using a sequence of images taken on the same functional biological area, such a method computes the auto/cross-correlation over the entire region. Since the diffusive parameters are extracted from the autocorrelation map as an average over a region of interest, stICS can be susceptible to spatial inhomogeneities of the fluorescent moiety in the same area. However, vesicles, membranes, confinements are sometimes poorly detectable from the sole fluorescence intensity. If different diffusion pools are present, some of them may be missed from the analysis of the global autocorrelation curve on account of the signal-to-noise ratio and/or their dynamic characteristics. This work explores different independent approaches to reveal the spatial feature of the molecular dynamics inside the cell. These approaches required a sequence of images to perform FCS analysis pixel by pixel. Each single-pixel autocorrelation evaluation avoids mixing different contributions due to average dynamics pools over a large field of view. Among the developed algorithm, the most promising is related to an analysis based on Maximum Entropy, which, for each point, gives a spectrum of Brownian Diffusion coefficients. This information can help link morphological and dynamics feature, also through correlative analysis with other spatial techniques, enabling new imaging schemes. These approaches are applied to recover membrane characteristics in cell's membrane such as PDL1, a significant player in an immune-checkpoint also involved in cancer progression.

Isolated tortuous ductus arteriosus in a fetus: HDlive Flow with spatiotemporal image correlation (STIC) study.

To describe prevalence, outcome, color Doppler, and HDlive Flow (Silhouette) with spatiotemporal image correlation (STIC) features of isolated tortuous ductus arteriosus in Japanese fetuses at 28-31+6weeks of gestation. During a 37-month period, 3,150 fetal screenings were performed at 28-31+6weeks of gestation. Isolated tortuous ductus arteriosus was evaluated using color Doppler and HDlive Flow (Silhouette) with STIC. Prevalence and outcomes were also assessed. There were 22/3,150 fetuses (0.7%) had isolated tortuous ductus arteriosus at 28-31+6weeks of gestation. According to color Doppler and HDlive Flow findings, two types of isolated tortuous ductus arteriosus (Right-angled and Loop shapes) were classified. There were 20 Right-angled and 2 Loop shapes. One fetus with a Right-angled shape was associated with aortic tortuosity. HDlive Flow with STIC revealed spatial relationships of tortuous ductus arteriosus, aortic arch, and descending aorta. All fetuses with isolated tortuous ductus arteriosus had good neonatal outcomes. The incidence of isolated tortuous ductus arteriosus in Japanese fetuses was low compared with those in previous reports. HDlive Flow with STIC provides precise information for spatial recognition and differentiation of isolated tortuous ductus arteriosus, resulting in two type classifications. Isolated tortuous ductus arteriosus in a fetus may be a transient, benign finding in utero.