No sonographer, no radiologist: New system for automatic prenatal detection of fetal biometry, fetal presentation, and placental location

Abstract

Ultrasound imaging is a vital component of high-quality Obstetric care. In rural and under-resourced communities, the scarcity of ultrasound imaging results in a considerable gap in the healthcare of pregnant mothers. To increase access to ultrasound in these communities, we developed a new automated diagnostic framework operated without an experienced sonographer or interpreting provider for assessment of fetal biometric measurements, fetal presentation, and placental position. This approach involves the use of a standardized volume sweep imaging (VSI) protocol based solely on external body landmarks to obtain imaging without an experienced sonographer and application of a deep learning algorithm (U-Net) for diagnostic assessment without a radiologist. Obstetric VSI ultrasound examinations were performed in Peru by an ultrasound operator with no previous ultrasound experience who underwent 8 hours of training on a standard protocol. The U-Net was trained to automatically segment the fetal head and placental location from the VSI ultrasound acquisitions to subsequently evaluate fetal biometry, fetal presentation, and placental position. In comparison to diagnostic interpretation of VSI acquisitions by a specialist, the U-Net model showed 100% agreement for fetal presentation (Cohen’s κ 1 (p<0.0001)) and 76.7% agreement for placental location (Cohen’s κ 0.59 (p<0.0001)). This corresponded to 100% sensitivity and specificity for fetal presentation and 87.5% sensitivity and 85.7% specificity for anterior placental location. The method also achieved a low relative error of 5.6% for biparietal diameter and 7.9% for head circumference. Biometry measurements corresponded to estimated gestational age within 2 weeks of those assigned by standard of care examination with up to 89% accuracy. This system could be deployed in rural and underserved areas to provide vital information about a pregnancy without a trained sonographer or interpreting provider. The resulting increased access to ultrasound imaging and diagnosis could improve disparities in healthcare delivery in under-resourced areas.

Volume sweep imaging lung teleultrasound for detection of COVID-19 in Peru: a multicentre pilot study

“…Future studies should also deploy the protocol into areas with high prevalence of pneumonia or other respiratory illness. Consideration can also be made to integrating VSI with artificial intelligence to allow for automatic diagnosis without a sonographer or radiologist 30–36…”

“…Consideration can also be made to integrating VSI with artificial intelligence to allow for automatic diagnosis without a sonographer or radiologist. [30][31][32][33][34][35][36] CONCLUSION Most of the individuals in the world are thought to lack access to diagnostic imaging. In this study, we piloted the use of a low-cost lung VSI teleultrasound system that can be operated by an individual without prior ultrasound experience after a few hours of training which could help increase access to imaging in populations with the greatest need.…”

Evaluation of an artificial intelligence algorithm (HeartAssistᵀᴹ) in the assessment of fetal cardiothoracic ratio: a prospective study

“…Although there is evidence that manual measurement of the C/T ratio is fairly reproducible, this is to the best of our knowledge the first test of the role of artificial intelligencebased software in measuring cardiac biometry. Automatic biometry has already been tested in the past to obtain standard fetal biometric variables [8][9][10][11] and for the study of the fetal central nervous system [12,13], proving to be compatible with the routine ultrasonographic workflow. The study of fetal heart biometry is challenging because its size is affected by the cardiac cycle.…”

Ultrasound robots: ready-to-use solutions and perspective directions.

“…Перспективным видится совмещение роботов и протоколов, таких как FAST, используемых в неотложной медицинской помощи для экстренной диагностики травм, однако подобные примеры в литературе не были найдены [38]. Но в настоящее время проводятся исследования и внедрения в клиническую практику упрощенных протоколов проведения УЗИ, которые позволяют выполнять ультразвуковое обследование персоналу без опыта проведения УЗИ и знания анатомических структур [39,40]. В таком случае данные, полученные по определенному алгоритму движения датчика, сохраняются и передаются врачу ультразвуковой диагностики для дальнейшего анализа.…”