Dataset Information

Optimization of Fetal Biometry With 3D Ultrasound and Image Recognition (EPICEA): protocol for a prospective cross-sectional study.

ABSTRACT: CONTEXT:Variability in 2D ultrasound (US) is related to the acquisition of planes of reference and the positioning of callipers and could be reduced in combining US volume acquisitions and anatomical structures recognition. OBJECTIVES:The primary objective is to assess the consistency between 3D measurements (automated and manual) extracted from a fetal US volume with standard 2D US measurements (I). Secondary objectives are to evaluate the feasibility of the use of software to obtain automated measurements of the fetal head, abdomen and femur from US acquisitions (II) and to assess the impact of automation on intraobserver and interobserver reproducibility (III). METHODS AND ANALYSIS:225 fetuses will be measured at 16-30 weeks of gestation. For each fetus, six volumes (two for head, abdomen and thigh, respectively) will be prospectively acquired after performing standard 2D biometry measurements (head and abdominal circumference, femoral length). Each volume will be processed later by both a software and an operator to extract the reference planes and to perform the corresponding measurements. The different sets of measurements will be compared using Bland-Altman plots to assess the agreement between the different processes (I). The feasibility of using the software in clinical practice will be assessed through the failure rate of processing and the score of quality of measurements (II). Interclass correlation coefficients will be used to evaluate the intraobserver and interobserver reproducibility (III). ETHICS AND DISSEMINATION:The study and related consent forms were approved by an institutional review board (CPP SUD-EST 3) on 2 October 2018, under reference number 2018-033 B. The study has been registered in https://clinicaltrials.gov registry on 23 January 2019, under the number NCT03812471. This study will enable an improved understanding and dissemination of the potential benefits of 3D automated measurements and is a prerequisite for the design of intention to treat randomised studies assessing their impact. TRIAL REGISTRATION NUMBER:NCT03812471; Pre-results.

SUBMITTER: Ambroise Grandjean G

PROVIDER: S-EPMC6924693 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Optimization of Fetal Biometry With 3D Ultrasound and Image Recognition (EPICEA): protocol for a prospective cross-sectional study.

Ambroise Grandjean Gaëlle G Hossu Gabriela G Banasiak Claire C Ciofolo-Veit Cybele C Raynaud Caroline C Rouet Laurence L Morel Olivier O Beaumont Marine M

BMJ open 20191215 12

<h4>Context</h4>Variability in 2D ultrasound (US) is related to the acquisition of planes of reference and the positioning of callipers and could be reduced in combining US volume acquisitions and anatomical structures recognition.<h4>Objectives</h4>The primary objective is to assess the consistency between 3D measurements (automated and manual) extracted from a fetal US volume with standard 2D US measurements (I). Secondary objectives are to evaluate the feasibility of the use of software to ob ...[more]

PMID: 31843832

Similar Datasets

Project description:Background/Objectives: To evaluate the quality of an ultrasound practice, both large-scale and focused audits are recommended by professional organizations, but such audits can be time-consuming, inefficient, and expensive. Our objective was to develop a time-efficient, quantitative, objective, large-scale method to evaluate fetal biometry measurements for an entire practice, combined with a process for focused image review for personnel whose measurements are outliers. Methods: Ultrasound exam data for a full year are exported from commercial ultrasound reporting software to a statistical package. Fetal biometry measurements are converted to z-scores to standardize across gestational ages. For a large-scale audit, sonographer mean z-scores are compared using analysis of variance (ANOVA) with Scheffe multiple comparisons test. A focused image review is performed on a random sample of exams for sonographers whose mean z-scores differ significantly from the practice mean. A similar large-scale audit is performed, comparing physician mean z-scores. Results: Using fetal abdominal circumference measurements as an example, significant differences between sonographer mean z-scores are readily identified by the ANOVA and Scheffe test. A method is described for the blinded image audit of sonographers with outlier mean z-scores. Examples are also given for the identification and interpretation of several types of systematic errors that are unlikely to be detectable by image review, including z-scores with large or small standard deviations and physicians with outlier mean z-scores. Conclusions: The large-scale quantitative analysis provides an overview of the biometry measurements of all the sonographers and physicians in a practice, so that image audits can be focused on those whose measurements are outliers. The analysis takes little time to perform after initial development and avoids the time, complexity, and expense of auditing providers whose measurements fall within the expected range. We encourage commercial software developers to include tools in their ultrasound reporting software to facilitate such quantitative reviews.

Project description:PurposeIn this paper we compared two different 3D ultrasound (US) modes (3D free-hand mode and 3D wobbler mode) to see which is more suitable to perform the 3D-US/3D-US registration for clinical guidance applications. The typical errors with respect to their impact on the final localization error were evaluated step by step.MethodsMulti-point target and Hand-eye calibration methods were used for 3D US calibration together with a newly designed multi-cone phantom. Pointer based and image based methods were used for 2D US calibration. The calibration target error was computed by using a different multi-cone phantom. An egg-shaped phantom was used as ground truth to compare distortions for both 3D modes along with the measurements of the volume. Finally, we compared 3D ultrasound images acquired by 3D wobbler mode and 3D free-hand mode with respect to their 3D-US/3D-US registration accuracy using both, phantom and patient data. A theoretical step by step error analysis was performed and compared to empirical data.ResultsTarget registration errors based on the calibration with the 3D Multi-point and 2D pointer/image method have been found to be comparable (∼1mm). They both outperformed the 3D Hand-eye method (error >2mm). Volume measurements with the 3D free-hand mode were closest to the ground truth (around 6% error compared to 9% with the 3D wobbler mode). Additional scans on phantoms showed a 3D-US/3D-US registration error below 1 mm for both, the 3D free-hand mode and the 3D wobbler mode, respectively. Results with patient data showed greater error with the 3D free-hand mode (6.50mm - 13.37mm) than with the 3D wobbler mode (2.99 ± 1.54 mm). All the measured errors were found to be in accordance to their theoretical upper bounds.ConclusionWhile both 3D volume methods showed comparable results with respect to 3D-US/3D-US registration for phantom images, for patient data registrations the 3D wobbler mode is superior to the 3D free-hand mode. The effect of all error sources could be estimated by theoretical derivations.

Project description:BackgroundFour million premature deaths occur yearly as a result of smoke from cooking fires. The Ghana Randomized Air Pollution and Health Study (GRAPHS) is underway in the Kintampo North municipality and South district of rural Ghana to evaluate the impact of improved cook stoves introduced during pregnancy on birth weight and childhood pneumonia. These hypotheses are being tested in a cluster-randomized intervention trial among 1415 maternal-infant pairs within 35 communities assigned to a control arm (traditional cooking) or one of two intervention arms (cooking with an improved biomass stove; cooking with liquefied petroleum gas stoves).ObjectiveThe trial is designed to ensure delivery of the stove intervention prior to the period of maximal fetal growth. To answer questions about the impact of household air pollution on pregnancy outcome, accurate gestational age assessment is critical. This manuscript describes in detail the development of the gestational dating protocol, intensive ultrasound training involved, ultrasound capacity building, and ultrasound quality control program.MethodsUltrasound training occurred in several phases over the course of 2 years. Training included a basic obstetric ultrasound course offered to all midwives performing antenatal care at the two study hospitals, followed by a more intense period of hands-on training focused on fetal biometry for a select group of providers demonstrating aptitude in the basic course. A standard operating procedure was developed describing how to obtain all fetal biometric measurements. Consensus was obtained on how biometric images are used in the trial to establish gestational age and estimate the delivery date. An ongoing ultrasound quality control program including the use of an image scorecard was also designed.ResultsPublication of trial results is anticipated in late 2016.ConclusionsUse of ultrasound should be strongly considered in field-based trials involving pregnant women to accurately establish gestational age, as menstrual dates may be incorrect or unknown. The inclusion of ultrasound in areas where ultrasound capacity does not previously exist requires a significant investment of time and resources. Such investment ensures appropriate training, high quality images, and accurate dating pregnancies. We outline our ultrasound training, image acquisition, quality control, and dating protocols in detail.Trial registrationClinicaltrials.gov NCT01335490; http://clinicaltrials.gov/ct2/show/NCT01335490 (Archived by WebCite at http://www.webcitation.org/6UbERJNO6).

Dataset Information

Optimization of Fetal Biometry With 3D Ultrasound and Image Recognition (EPICEA): protocol for a prospective cross-sectional study.

Publications

Optimization of Fetal Biometry With 3D Ultrasound and Image Recognition (EPICEA): protocol for a prospective cross-sectional study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets