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<b>Novel 3D-Extended Field of View Ultrasound (eFoV) for Whole Fetal Body Volumetry:</b> <i>Feasibility and Comparison with 2D Ultrasound and MRI for Fetal Weight Calculation</i>
Poster Title: Novel 3D-Extended Field of View Ultrasound (eFoV) for Whole Fetal Body Volumetry: Feasibility and Comparison with 2D Ultrasound and MRI for Fetal Weight Calculation
Submitted on 10 Sep 2018
Author(s): Skelton E, Matthew J, Gomez A.
Affiliations: School of Biomedical Engineering and Imaging Sciences, King's College London
This poster was presented at BIR Annual Congress 2018
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Poster Information
Abstract: Background
An accurate estimated fetal weight (EFW) is essential for the delivery of good quality antenatal care. Current 2D ultrasound (2DUS) methods are susceptible to limiting factors which can induce errors of up to 15%.1 Fetal magnetic resonance imaging (MRI) volume-derived EFW may be a more accurate alternative to 2DUS methods.2 We utilised a novel method of 3D-extended field of view (eFoV) ultrasound (US) to extract whole fetal body volumes (WFBV) to assess the feasibility of this technology in comparison to MRI volumetry and conventional 2DUS EFW calculations.
Data collected as part of the intelligent fetal imaging and diagnosis (iFIND) project (ISRCTN = 16542843). 5 healthy mid=pregnancy (mean gestational age = 23 completed weeks) paired fetal US and MRI scans were retrospectively selected. Our 3D-eFoV US technology was used to produce a whole fetal body compounded volume prior to segmentation.3 Balanced Turbo Field Echo (BTFE) fetal MRI sequences were used for the MRI WFBV semi-automated segmentations. Subjective quality of the segmentation was assessed along with a comparison of mean percentage difference (MPD) between conventional 2DUS EFW, 3D-eFoV US EFW and MRI-volume EFW (Baker formula).4
The MPD between 3D-eFoV US EFW and MRI-volume EFW was 6.3% (36.26ml), the MPD between 3D-eFoV US EFW and 2DUS EFW was 5.5% (28.19g). Compared to 2DUS EFW, MRI-volume EFW performed slightly worse (MPD = 10% / 54.47g). This is comparable with our previous work.5 Both techniques are susceptible to fetal movement artefact during volume acquisition which can degrade image quality and subsequent volume calculation. Superior contrast and soft tissue delineation renders MRI segmentation easier than 3D-eFoV segmentation,
It is feasible for 3D-eFoV US to generate volumes for segmentation and calculation of WFBV-derived EFW. A larger sample size is essential for statistical analysis. Further refinement of the technique is required to improve contrast boundary delineation and completeness of anatomical coverage in 3D-eFoV US. Differences between MRI and US EFW may be related to use of Baker's formula to calculate MRI WFBV EFW which was originally based on 3rd trimester fetuses and may therefore not consider varying fetal density at earlier gestations. Due to known limitations of 2DUS EFW, future comparison with actual birthweight may provide more consistent results, although this is not often feasible in the mid-trimester fetus.
Summary: A feasibility study of our novel 3D-extended field of view ultrasound (3d- eFoV US) technique for volumetric calculation of estimated fetal weight (EFW) compared with conventional 2D ultrasound and MRI methods.References: 1) Dudley, N. A review of ultrasound fetal weight estimation in the early prediction of low birthweight. Ultrasound 2013; 21(4): 181-186.
2) Dudley, N. A systematic review of the ultrasound estimation of fetal weight. Ultrasound Obstet Gynecol. 2005;25:80-89
3) Gomez, A., Bhatia, K., Tharin, S., Housden, J., Toussaint, N., Schnabel, J.A. Fast Registration of 3D Fetal Ultrasound Images Using Learned Corresponding Salient Points. In: Cardoso M. et al. (eds) Fetal, Infant and Ophthalmic Medical Image Analysis. OMIA 2017, FIFI 2017. Lecture Notes in Computer Science, vol 10554. Springer, Cham
4) Baker, P.N., Johnson I.R., Gowland P.A., Hykin J., Harvey P.R., Freeman A., et al. Fetal weight estimation by echo-planar magnetic resonance imaging. Lancet. 1994;343(8898):644-645.
5) Skelton, E., Matthew, J., Story, L., Davidson, A., Gupta, C., Knight, C., Pasupathy, D., Rutherford, M. MRI volume-derived estimated fetal weight in the mid-pregnancy fetus: A comparison with current
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