Prospective evaluation of the fetal heart using Fetal Intelligent Navigation Echocardiography (FINE)

Abstract

Objective To evaluate prospectively the performance of Fetal Intelligent Navigation Echocardiography (FINE) applied to spatiotemporal image correlation (STIC) volume datasets of the normal fetal heart. Methods In all women between 19 and 30 weeks of gestation with a normal fetal heart, an attempt was made to acquire STIC volume datasets of the apical four-chamber view if the following criteria were met: 1) fetal spine located between the 5- and 7-o’clock positions; 2) minimal or absent shadowing (including a clearly visible transverse aortic arch); 3) absence of fetal breathing, hiccups, or movement; and 4) adequate image quality. Each STIC volume successfully acquired was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates of fetal echocardiography views using diagnostic planes and/or Virtual Intelligent Sonographer Assistance (VIS-Assistance®) were calculated. Results One or more STIC volumes (365 in total) were successfully obtained in 72.5% (150/207) of women undergoing ultrasound examination. Of the 365 volumes evaluated by STICLoop, 351 (96.2%) were considered to be appropriate. From the 351 STIC volumes, only one STIC volume per patient (n=150) was analyzed using the FINE method; consequently, nine fetal echocardiography views were generated in 76–100% of cases using diagnostic planes only; in 98–100% of cases using VIS-Assistance only; and in 98–100% of cases when using a combination of diagnostic planes and/or VIS-Assistance. Conclusions In women between 19 and 30 weeks of gestation with a normal fetal heart undergoing prospective sonographic examination, STIC volumes can be successfully obtained in 72.5% of cases. The FINE method can be applied to generate nine standard fetal echocardiography views in 98–100% of these cases using a combination of diagnostic planes and or VIS-Assistance. This suggests that FINE could be implemented in fetal cardiac screening programs.

The Diagnostic Accuracy of Automated Fetal Heart Echocardiography by Five Dimensional Compared to Two-Dimensional Ultrasound in the Second Trimester of Pregnancy

“…The difference in the percentage of satisfactory rating views between the two methods was 1.73% (95% CI, 0.5% -3.33%) with P value of 0.144 which is insignificant. Our results showed a strong agreement with other investigators as Garcia M et al [4], who found that FINE was successful to generate the nine planes in 98% -100% of cases and also Veronese P et al [10] who found that FINE was successful to generate the nine planes in 96% -100% of cases.…”

“…To make the matter more challenging, it is estimated that nearly 90% of congenital cardiac defects are present in low risk pregnancy [4]. The need for an accurate method to detect fetal cardiac anomalies in low and high risk pregnant women is obvious, still routine antenatal ultrasound examination has a sensitivity of almost 50% only fordetection of fetal cardiac anomalies [5], in majority of cases, this is attributed to lack of sonographer experience to detect these cardiac defects [6].…”

“…With the development of 5DUS technology which is a form of automation that brings the results of 3D and 4DUS in an automated form to reduce the effect of Operator bias [4].…”

Fetal Intelligent Navigation Echocardiography (FINE) Detects 98% of Congenital Heart Disease

“…As a result, FINE has been suggested as a method to screen for CHD. 78,79 However, to be clinically useful, a screening test should demonstrate both good specificity and sensitivity. 81 Therefore, we conducted this study to determine the sensitivity and specificity of FINE in the prenatal detection of CHD.…”

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

“…Fetal Intelligent Navigation Echocardiography (FINE) has recently emerged as a novel approach to examine the fetal heart after a STIC volume has been acquired [56-58]. Such method allows the automatic generation and display of nine standard fetal echocardiography views in normal hearts, including those universally recommended by professional organizations, such as the American Institute of Ultrasound in Medicine (AIUM) and International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) [59,60].…”