Alvaro Perez-Moreno

Feasibility and reproducibility of fetal lung texture analysis by Automatic Quantitative Ultrasound Analysis and correlation with gestational age.

Objective: To evaluate the feasibility and reproducibility of fetal lung texture analysis using a novel automatic quantitative ultrasound analysis and to assess its correlation with gestational age. Methods: Prospective cross-sectional observational study. To evaluate texture features, 957 left and right lung images in a 2D four-cardiac-chamber view plane were previously delineated from fetuses between 20 and 41 weeks of gestation. Quantification of lung texture was performed by the Automatic Quantitative Ultrasound Analysis (AQUA) software to extract image features. A standard learning approach composed of feature transformation and a regression model was used to evaluate the association between texture features and gestational age. Results: The association between weeks of gestation and fetal lung texture quantified by the AQUA software presented a Pearson correlation of 0.97. The association was not influenced by delineation parameters such as region of interest (ROI) localization, ROI size, right/left lung selected or sonographic parameters such as ultrasound equipment or transducer used. Conclusions: Fetal lung texture analysis measured by the AQUA software demonstrated a strong correlation with gestational age. This supports further research to explore the use of this technology to the noninvasive prediction of fetal lung maturity.

Quantitative ultrasound texture analysis of fetal lungs to predict neonatal respiratory morbidity

To develop and evaluate the performance of a novel method for predicting neonatal respiratory morbidity based on quantitative analysis of the fetal lung by ultrasound.

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study

BACKGROUND: Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. OBJECTIVE: The objective of the study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early‐term (<39.0 weeks) deliveries. STUDY DESIGN: This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0–38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. RESULTS: A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101 of 730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, positive and negative predictive values of 74.3% (75 of 101), 88.6% (557 of 629), 51.0% (75 of 147), and 95.5% (557 of 583), respectively. Accuracy was 86.5% (632 of 730) and positive and negative likelihood ratios were 6.5 and 0.3, respectively. CONCLUSION: The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a noninvasive technique.

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age

Objectives: Quantitative texture analysis has been proposed to extract robust features from the ultrasound image to detect subtle changes in the textures of the images. The aim of this study was to evaluate the feasibility of quantitative cervical texture analysis to assess cervical tissue changes throughout pregnancy. Methods: This was a cross-sectional study including singleton pregnancies between 20.0 and 41.6 weeks of gestation from women who delivered at term. Cervical length was measured, and a selected region of interest in the cervix was delineated. A model to predict gestational age based on features extracted from cervical images was developed following three steps: data splitting, feature transformation, and regression model computation. Results: Seven hundred images, 30 per gestational week, were included for analysis. There was a strong correlation between the gestational age at which the images were obtained and the estimated gestational age by quantitative analysis of the cervical texture (R = 0.88). Discussion: This study provides evidence that quantitative analysis of cervical texture can extract features from cervical ultrasound images which correlate with gestational age. Further research is needed to evaluate its applicability as a biomarker of the risk of spontaneous preterm birth, as well as its role in cervical assessment in other clinical situations in which cervical evaluation might be relevant.

Mid‐trimester sonographic cervical consistency index to predict spontaneous preterm birth in a low‐risk population

To investigate the effectiveness of mid‐trimester sonographic cervical consistency index (CCI) for the prediction of spontaneous preterm birth (sPTB) in low‐risk pregnancies and to compare its performance with that of mid‐trimester sonographic cervical‐length (CL) measurement.

Clinical Feasibility of Quantitative Ultrasound Texture Analysis: A Robustness Study Using Fetal Lung Ultrasound Images

To compare the robustness of several methods based on quantitative ultrasound (US) texture analysis to evaluate its feasibility for extracting features from US images to use as a clinical diagnostic tool.

Contents Vol. 41, 2017

R. Achiron, Tel Hashomer N.S. Adzick, Philadelphia, PA L. Allan, London A.A. Baschat, Baltimore, MD K.J. Blakemore, Baltimore, MD T.-H. Bui, Stockholm F.A. Chervenak, New York, NY T. Chiba, Tokyo R. Chmait, Los Angeles, CA F. Crispi, Barcelona J.E. De Lia, Milwaukee, WI J.A. Deprest, Leuven G.C. Di Renzo, Perugia J.W. Dudenhausen, Berlin N.M. Fisk, Brisbane, QLD A.W. Flake, Philadelphia, PA U. Gembruch, Bonn M.R. Harrison, San Francisco, CA J.C. Hobbins, Denver, CO L.K. Hornberger, Edmonton, AB E.R.M. Jauniaux, London M.P. Johnson, Philadelphia, PA J.-M. Jouannic, Paris P.M. Kyle, London O. Lapaire, Basel S. Lipitz, Tel Hashomer E. Llurba, Barcelona G. Malinger, Tel Aviv G. Mari, Detroit, MI M. Martinez-Ferro, Buenos Aires A. McLennan, Sydney, NSW K.J. Moise, Houston, TX F. Molina, Granada K.H. Nicolaides, London L. Otaño, Buenos Aires Z. Papp, Budapest R.A. Quintero, Miami, FL G. Ryan, Toronto, ON J. Rychik, Philadelphia, PA H. Sago, Tokyo W. Sepulveda, Santiago P. Stone, Auckland D.V. Surbek, Bern B.J. Trudinger, Westmead, NSW Y. Ville, Paris J.M.G. van Vugt, Nijmegen Clinical Advances and Basic Research

Consistent association between image features of fetal lungs from different ultrasound equipments and fetal lung maturity from amniocentesis

Respiratory disorders in premature are outlined as one of the major causes of newborn morbidity. Therefore, estimation in utero of the risk that a particular newborn will present respiratory distress syndrome is critical in perinatal medicine. Fetal lung maturity assessment by non-invasive methods is an unsolved problem since 80s. There has been a significant effort reporting that ultrasound images carry information associated with changes of fetal lung microstructure but it required the lung-to-liver measurements to be calibrated, which limits clinical feasibility. In this work, we explored the association between image features only from a fetal lung computed by a previously reported probabilistic model and fetal lung maturity. Two studies validated image features obtained from different US equipments: 957 scans were correlated to gestational age (r>;0.97); and 83 scans were modeled to estimate a normalized lung maturity index in 7 blind samples. Bootstrapping provided median r>;0.82.

OC09.06: Semiautomatic endocardium deformation analysis to assess fetal cardiac function: clinical feasibility and comparison with tissue Doppler imaging

A STIC volume was also acquired and saved. In post-processing, the volume was rotated to show an apical 4CV. M-mode was applied to the tricuspid annulus, and the amplitude of the resulting wave was measured (mm). Three TAPSE measures were taken and results averaged. Measurements were performed by two observers and interand intra-observer variations were calculated. Results: 50 women were recruited at 20 to 38 wks. STIC-TAPSE values were plotted against GA and estimated fetal weight, and these scatterplots compared to those obtained from conventional M-mode TAPSE. Good correlation was found between the two methods. Interand intra-observer variation in STIC-TAPSE were < 15%. Length of post-processing measurement was 30–60 seconds, and decreased following a learning curve. Conclusions: STIC-TAPSE is easy to perform and can be measured even on archival cases. We suggest that this measure may be added to the basket of tests of right heart function, such as ventricular volume, ventricular mass, ejection fraction, etc.