Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for second-trimester anomaly screening, for which ultrasound (US) is employed. Although expert sonographers are adept at reading US images, MR images which closely resemble anatomical images are much easier for non-experts to interpret. Thus in this paper we propose to generate MR-like images directly from clinical US images. In medical image analysis such a capability is potentially useful as well, for instance for automatic US-MRI registration and fusion. The proposed model is end-to-end trainable and self-supervised without any external annotations. Specifically, based on an assumption that the US and MRI data share a similar anatomical latent space, we first utilise a network to extract the shared latent features, which are then used for MRI synthesis. Since paired data is unavailable for our study (and rare in practice), pixel-level constraints are infeasible to apply. We instead propose to enforce the distributions to be statistically indistinguishable, by adversarial learning in both the image domain and feature space. To regularise the anatomical structures between US and MRI during synthesis, we further propose an adversarial structural constraint. A new cross-modal attention technique is proposed to utilise non-local spatial information, by encouraging multi-modal knowledge fusion and propagation. We extend the approach to consider the case where 3D auxiliary information (e.g., 3D neighbours and a 3D location index) from volumetric data is also available, and show that this improves image synthesis. The proposed approach is evaluated quantitatively and qualitatively with comparison to real fetal MR images and other approaches to synthesis, demonstrating its feasibility of synthesising realistic MR images.
Diffusion Model-based Data Augmentation Method for Fetal Head Ultrasound Segmentation
Research Ireland Centre for Research Training in Machine Learning（爱尔兰研究机器学习研究中心）；School of Medicine, University College Dublin（都柏林大学医学院）；School of Computer Science, University College Dublin（都柏林大学计算机科学学院）
Sano Centre for Computational Medicine（萨诺计算医学中心）；Warsaw University of Technology（华沙理工大学）；Fetai Health Ltd.（Fetai健康有限公司）；Medical University of Warsaw（华沙医科大学）；Tooploox（Tooploox公司）
In this paper, we propose an end-to-end multi-task neural network called FetalNet with an attention mechanism and stacked module for spatio-temporal fetal ultrasound scan video analysis. Fetal biometric measurement is a standard examination during pregnancy used for the fetus growth monitoring and estimation of gestational age and fetal weight. The main goal in fetal ultrasound scan video analysis is to find proper standard planes to measure the fetal head, abdomen and femur. Due to natural high speckle noise and shadows in ultrasound data, medical expertise and sonographic experience are requ…
Isfahan University of Technology（伊斯法罕理工大学）；University of Michigan（密歇根大学）
Ultrasound imaging is a standard examination during pregnancy that can be used for measuring specific biometric parameters towards prenatal diagnosis and estimating gestational age. Fetal head circumference (HC) is one of the significant factors to determine the fetus growth and health. In this paper, a multi-task deep convolutional neural network is proposed for automatic segmentation and estimation of HC ellipse by minimizing a compound cost function composed of segmentation dice score and MSE of ellipse parameters. Experimental results on fetus ultrasound dataset in different trimesters of …
University College London（伦敦大学学院）；Elizabeth Garrett Anderson Institute for Women’s Health, University College London（伦敦大学学院伊丽莎白·加勒特·安德森妇女健康研究所）；NIHR University College London Hospitals Biomedical Research Centre（英国国家健康研究所伦敦大学学院医院生物医学研究中心）
During pregnancy, ultrasound examination in the second trimester can assess fetal size according to standardized charts. To achieve a reproducible and accurate measurement, a sonographer needs to identify three standard 2D planes of the fetal anatomy (head, abdomen, femur) and manually mark the key anatomical landmarks on the image for accurate biometry and fetal weight estimation. This can be a time-consuming operator-dependent task, especially for a trainee sonographer. Computer-assisted techniques can help in automating the fetal biometry computation process. In this paper, we present a uni…
Sagol Brain Institute, Tel Aviv Sourasky Medical Center（特拉维夫苏拉斯基医疗中心萨戈尔脑研究所）；University College London（伦敦大学学院）
Fetal growth assessment from ultrasound is based on a few biometric measurements that are performed manually and assessed relative to the expected gestational age. Reliable biometry estimation depends on the precise detection of landmarks in standard ultrasound planes. Manual annotation can be time-consuming and operator dependent task, and may results in high measurements variability. Existing methods for automatic fetal biometry rely on initial automatic fetal structure segmentation followed by geometric landmark detection. However, segmentation annotations are time-consuming and may be inac…
Sano Centre for Computational Medicine（萨诺计算医学中心）；Informatics Institute, University of Amsterdam（阿姆斯特丹大学信息学研究所）；The Medical Centre of Postgraduate Education（研究生教育医学中心）；Poznan University of Medical Sciences（波兹南医科大学）；Medical University of Warsaw（华沙医科大学）；Warsaw University of Technology（华沙理工大学）
Predicting fetal weight at birth is an important aspect of perinatal care, particularly in the context of antenatal management, which includes the planned timing and the mode of delivery. Accurate prediction of weight using prenatal ultrasound is challenging as it requires images of specific fetal body parts during advanced pregnancy which is difficult to capture due to poor quality of images caused by the lack of amniotic fluid. As a consequence, predictions which rely on standard methods often suffer from significant errors. In this paper we propose the Residual Transformer Module which exte…
Università Politecnica delle Marche（马尔凯理工大学）；Università degli Studi di Macerata（马切拉塔大学）；Scuola Superiore Sant’Anna（圣安娜高等学校）
Deep-learning (DL) algorithms are becoming the standard for processing ultrasound (US) fetal images. Despite a large number of survey papers already present in this field, most of them are focusing on a broader area of medical-image analysis or not covering all fetal US DL applications. This paper surveys the most recent work in the field, with a total of 145 research papers published after 2017. Each paper is analyzed and commented on from both the methodology and application perspective. We categorized the papers in (i) fetal standard-plane detection, (ii) anatomical-structure analysis, and …
FetalCLIP: A Visual-Language Foundation Model for Fetal Ultrasound Image Analysis
Department of Computer Vision（计算机视觉系）；Mohamed bin Zayed University of Artificial Intelligence（马尔代夫比兹人工智能大学）；Department of Machine Learning（机器学习系）；Corniche Hospital, Abu Dhabi Health Services Company (SEHA)（阿布扎赫尔医院，阿布扎赫健康服务公司（SEHA））
Google Health（谷歌健康）；University of Zambia School of Medicine（赞比亚大学医学院）；University of North Carolina School of Medicine（北卡罗来纳大学医学院）；UNC Global Projects – Zambia, LLC（北卡罗来纳大学全球项目赞比亚有限责任公司）
Despite considerable progress in maternal healthcare, maternal and perinatal deaths remain high in low-to-middle income countries. Fetal ultrasound is an important component of antenatal care, but shortage of adequately trained healthcare workers has limited its adoption. We developed and validated an artificial intelligence (AI) system that uses novice-acquired "blind sweep" ultrasound videos to estimate gestational age (GA) and fetal malpresentation. We further addressed obstacles that may be encountered in low-resourced settings. Using a simplified sweep protocol with real-time AI feedback …
Imperial College London（帝国理工学院）；King’s College London（伦敦国王学院）；Guy’s and St Thomas’ NHS Foundation Trust（盖伊和圣托马斯国民保健服务基金会信托）；City, University of London（伦敦城市大学）；Technical University of Munich（慕尼黑工业大学）
Fetal ultrasound screening during pregnancy plays a vital role in the early detection of fetal malformations which have potential long-term health impacts. The level of skill required to diagnose such malformations from live ultrasound during examination is high and resources for screening are often limited. We present an interpretable, atlas-learning segmentation method for automatic diagnosis of Hypo-plastic Left Heart Syndrome (HLHS) from a single `4 Chamber Heart' view image. We propose to extend the recently introduced Image-and-Spatial Transformer Networks (Atlas-ISTN) into a framework t…
Objective. This work investigates the use of deep convolutional neural networks (CNN) to automatically perform measurements of fetal body parts, including head circumference, biparietal diameter, abdominal circumference and femur length, and to estimate gestational age and fetal weight using fetal ultrasound videos. Approach. We developed a novel multi-task CNN-based spatio-temporal fetal US feature extraction and standard plane detection algorithm (called FUVAI) and evaluated the method on 50 freehand fetal US video scans. We compared FUVAI fetal biometric measurements with measurements made …
In this work, we present an empirical study of DCGANs, including hyperparameter heuristics and image quality assessment, as a way to address the scarcity of datasets to investigate fetal head ultrasound. We present experiments to show the impact of different image resolutions, epochs, dataset size input, and learning rates for quality image assessment on four metrics: mutual information (MI), Fréchet inception distance (FID), peak-signal-to-noise ratio (PSNR), and local binary pattern vector (LBPv). The results show that FID and LBPv have stronger relationship with clinical image quality score…
Improving cross-domain brain tissue segmentation in fetal MRI with synthetic data
Lausanne University Hospital（洛桑大学医院）；University of Lausanne (UNIL)（洛桑大学）；CIBM Center for Biomedical Imaging（CIBM生物医学成像中心）；King’s College London（伦敦国王学院）；FAU Erlangen-Nuremberg（埃尔朗根-纽伦堡大学）
Romanian Institute of Science and Technology（罗马尼亚科学技术研究所）；University of Medicine and Pharmacy of Craiova（克拉约瓦医药大学）
The present paper puts forward an incipient study that uses a traditional segmentation method based on Zernike moments for extracting significant features from frames of fetal echocardiograms from first trimester color Doppler examinations. A distance based approach is then used on the obtained indicators to classify frames of three given categories that should be present in a normal heart condition. The computational tool shows promise in supporting the obstetrician in a rapid recognition of heart views during screening.
Fusing Radiomic Features with Deep Representations for Gestational Age Estimation in Fetal Ultrasound Images
Research Ireland Centre for Research Training in Machine Learning（爱尔兰研究培训机器学习研究中心）；School of Medicine, University College Dublin（都柏林大学医学院）；School of Veterinary Medicine, University College Dublin（都柏林大学兽医学院）；School of Computer Science, University College Dublin（都柏林大学计算机科学学院）
Cross-Modal Ultrasound-MRI Learning for Fetal Brain Ventricular Volumetry and Abnormality Screening
Harvard Medical School（哈佛医学院）；Shenzhen University（深圳大学）；Centre for Artificial Intelligence and Robotics, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences（中国科学院香港创新研究院人工智能与机器人中心）；School of Artificial Intelligence, Shenzhen University（深圳大学人工智能学院）；School of Biomedical Engineering and Informatics, Nanjing Medical University（南京医科大学生物医学工程与信息学院）
Imperial College London（伦敦帝国学院）；King’s College London（伦敦国王学院）；St Thomas’ Hospital（圣托马斯医院）
Prenatal screening with ultrasound can lower neonatal mortality significantly for selected cardiac abnormalities. However, the need for human expertise, coupled with the high volume of screening cases, limits the practically achievable detection rates. In this paper we discuss the potential for deep learning techniques to aid in the detection of congenital heart disease (CHD) in fetal ultrasound. We propose a pipeline for automated data curation and classification. During both training and inference, we exploit an auxiliary view classification task to bias features toward relevant cardiac stru…
One of the routine examinations that are used for prenatal care in many countries is ultrasound imaging. This procedure provides various information about fetus health and development, the progress of the pregnancy and, the baby's due date. Some of the biometric parameters of the fetus, like fetal head circumference (HC), must be measured to check the fetus's health and growth. In this paper, we investigated the effects of using multi-scale inputs in the network. We also propose a light convolutional neural network for automatic HC measurement. Experimental results on an ultrasound dataset of …
MIT（麻省理工学院）；Tsinghua University（清华大学）；Boston Children’s Hospital（波士顿儿童医院）；Harvard Medical School（哈佛医学院）
The performance and diagnostic utility of magnetic resonance imaging (MRI) in pregnancy is fundamentally constrained by fetal motion. Motion of the fetus, which is unpredictable and rapid on the scale of conventional imaging times, limits the set of viable acquisition techniques to single-shot imaging with severe compromises in signal-to-noise ratio and diagnostic contrast, and frequently results in unacceptable image quality. Surprisingly little is known about the characteristics of fetal motion during MRI and here we propose and demonstrate methods that exploit a growing repository of MRI ob…
Shenzhen University（深圳大学）；Nanfang Medical University（南方医科大学）；The Chinese University of Hong Kong（香港中文大学）
Volumetric ultrasound has great potentials in promoting prenatal examinations. Automated solutions are highly desired to efficiently and effectively analyze the massive volumes. Segmentation and landmark localization are two key techniques in making the quantitative evaluation of prenatal ultrasound volumes available in clinic. However, both tasks are non-trivial when considering the poor image quality, boundary ambiguity and anatomical variations in volumetric ultrasound. In this paper, we propose an effective framework for simultaneous segmentation and landmark localization in prenatal ultra…
The Challenge of Fetal Cardiac MRI Reconstruction Using Deep Learning
King’s College London（伦敦国王学院）；Technical University of Munich（慕尼黑工业大学）；Imperial College London（帝国理工学院）；Guy’s & St. Thomas’ NHS Foundation Trust（盖伊和圣托马斯国民保健服务基金会信托）；Evelina London Children’s Hospital（伊夫琳娜伦敦儿童医院）
Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for anomaly screening. For this ultrasound (US) is employed. While expert sonographers are adept at reading US images, MR images are much easier for non-experts to interpret. Hence in this paper we seek to produce images with MRI-like appearance directly from clinical US images. Our own clinical motivation is to seek a way to communicate US findings to patients or clinical professionals unfamiliar with US, but in medical image analysis such a capability is potentially useful, for in…
Fetal growth restriction (FGR) is a prevalent pregnancy condition characterised by failure of the fetus to reach its genetically predetermined growth potential. We explore the application of model fitting techniques, linear regression machine learning models, deep learning regression, and Haralick textured features from multi-contrast MRI for multi-fetal organ analysis of FGR. We employed T2 relaxometry and diffusion-weighted MRI datasets (using a combined T2-diffusion scan) for 12 normally grown and 12 FGR gestational age (GA) matched pregnancies. We applied the Intravoxel Incoherent Motion M…
MIT（麻省理工学院）；Boston Children’s Hospital（波士顿儿童医院）；Harvard Medical School（哈佛医学院）
Fetal MRI is heavily constrained by unpredictable and substantial fetal motion that causes image artifacts and limits the set of viable diagnostic image contrasts. Current mitigation of motion artifacts is predominantly performed by fast, single-shot MRI and retrospective motion correction. Estimation of fetal pose in real time during MRI stands to benefit prospective methods to detect and mitigate fetal motion artifacts where inferred fetal motion is combined with online slice prescription with low-latency decision making. Current developments of deep reinforcement learning (DRL), offer a nov…
USFetal: Tools for Fetal Brain Ultrasound Compounding
A. I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland（A.I.维塔内恩分子科学研究所，健康科学学院，东芬兰大学）；Munich Center for Machine Learning (MCML) at the Technical University of Munich（慕尼黑技术大学机器学习中心（MCML））；Department of Radiology, Massachusetts General Hospital（麻省总医院放射科）；Harvard Medical School and Boston Children’s Hospital（哈佛医学院和波士顿儿童医院）
University of Oxford（牛津大学）；Amazon（亚马逊）；Kings College London（伦敦国王学院）
This paper presents a novel approach to automatic fetal brain biometry motivated by needs in low- and medium- income countries. Specifically, we leverage high-end (HE) ultrasound images to build a biometry solution for low-cost (LC) point-of-care ultrasound images. We propose a novel unsupervised domain adaptation approach to train deep models to be invariant to significant image distribution shift between the image types. Our proposed method, which employs a Dual Adversarial Calibration (DAC) framework, consists of adversarial pathways which enforce model invariance to; i) adversarial perturb…
Pose-GuideNet: Automatic Scanning Guidance for Fetal Head Ultrasound from Pose Estimation
Institute of Biomedical Engineering, University of Oxford（牛津大学生物医学工程研究所）；Nuffield Department of Women’s & Reproductive Health, University of Oxford（牛津大学纳菲尔德妇女与生殖健康系）
MIT（麻省理工学院）；Boston Children’s Hospital（波士顿儿童医院）；Harvard Medical School（哈佛医学院）
Fetal motion is unpredictable and rapid on the scale of conventional MR scan times. Therefore, dynamic fetal MRI, which aims at capturing fetal motion and dynamics of fetal function, is limited to fast imaging techniques with compromises in image quality and resolution. Super-resolution for dynamic fetal MRI is still a challenge, especially when multi-oriented stacks of image slices for oversampling are not available and high temporal resolution for recording the dynamics of the fetus or placenta is desired. Further, fetal motion makes it difficult to acquire high-resolution images for supervi…
One of the biggest challenges for deep learning algorithms in medical image analysis is the indiscriminate mixing of image properties, e.g. artifacts and anatomy. These entangled image properties lead to a semantically redundant feature encoding for the relevant task and thus lead to poor generalization of deep learning algorithms. In this paper we propose a novel representation disentanglement method to extract semantically meaningful and generalizable features for different tasks within a multi-task learning framework. Deep neural networks are utilized to ensure that the encoded features are…
Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford（牛津大学工程科学系生物医学工程研究所）；Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford（牛津大学约翰拉德克利夫医院妇产科）；Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford（牛津大学李兆基健康信息与发现中心大数据研究所）
To improve the performance of most neuroimiage analysis pipelines, brain extraction is used as a fundamental first step in the image processing. But in the case of fetal brain development, there is a need for a reliable US-specific tool. In this work we propose a fully automated 3D CNN approach to fetal brain extraction from 3D US clinical volumes with minimal preprocessing. Our method accurately and reliably extracts the brain regardless of the large data variation inherent in this imaging modality. It also performs consistently throughout a gestational age range between 14 and 31 weeks, rega…
Multi-Center Study on Deep Learning-Assisted Detection and Classification of Fetal Central Nervous System Anomalies Using Ultrasound Imaging
School of Mathematics and Statistics, Xiamen University of Technology（厦门理工学院数学与统计学院）；Department of Obstetrics, Xiamen University Affiliated First Hospital（厦门大学附属第一医院妇产科）
Uncertainty-Calibrated Explainable Artificial Intelligence for Fetal Ultrasound Plane Classification: A Systematic Review
Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg（卢森堡大学生命科学与医学系，科学、技术与医学学院）；Department of Biostatistics and Medical Informatics, Institute of Health Sciences, Ege University（伊兹密尔大学健康科学学院生物统计学与医学信息学系）
Automated Fetal Biometry Assessment with Deep Ensembles using Sparse-Sampling of 2D Intrapartum Ultrasound Images
Oxford Machine Learning in NeuroImaging Lab, Department of Computer Science, University of Oxford（牛津大学计算机科学系）；Visual Geometry Group, Department of Engineering Science, University of Oxford（牛津大学工程科学系）；College of Computing and Data Science, Nanyang Technological University（南洋理工大学计算科学与数据科学学院）
MIT（麻省理工学院）；Boston Children’s Hospital（波士顿儿童医院）；Harvard Medical School（哈佛医学院）
Fetal brain MRI is useful for diagnosing brain abnormalities but is challenged by fetal motion. The current protocol for T2-weighted fetal brain MRI is not robust to motion so image volumes are degraded by inter- and intra- slice motion artifacts. Besides, manual annotation for fetal MR image quality assessment are usually time-consuming. Therefore, in this work, a semi-supervised deep learning method that detects slices with artifacts during the brain volume scan is proposed. Our method is based on the mean teacher model, where we not only enforce consistency between student and teacher model…
Boston Children’s Hospital（波士顿儿童医院）；Harvard Medical School（哈佛医学院）；Hyperfine Research Inc.（Hyperfine研究公司）
Fetal magnetic resonance imaging (MRI) is challenged by uncontrollable, large, and irregular fetal movements. It is, therefore, performed through visual monitoring of fetal motion and repeated acquisitions to ensure diagnostic-quality images are acquired. Nevertheless, visual monitoring of fetal motion based on displayed slices, and navigation at the level of stacks-of-slices is inefficient. The current process is highly operator-dependent, increases scanner usage and cost, and significantly increases the length of fetal MRI scans which makes them hard to tolerate for pregnant women. To help b…
The Chinese University of Hong Kong（香港中文大学）；Shenzhen University（深圳大学）；Affiliated Shenzhen Maternal and Child Healthcare Hospital of Nanfang Medical University（南方医科大学附属深圳妇幼保健院）
Background and Objective: Biometric measurements of fetal head are important indicators for maternal and fetal health monitoring during pregnancy. 3D ultrasound (US) has unique advantages over 2D scan in covering the whole fetal head and may promote the diagnoses. However, automatically segmenting the whole fetal head in US volumes still pends as an emerging and unsolved problem. The challenges that automated solutions need to tackle include the poor image quality, boundary ambiguity, long-span occlusion, and the appearance variability across different fetal poses and gestational ages. In this…
