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Hesse LS, Aliasi M, Moser F, theINTERGROWTH-Twenty First Consortium, Haak MC, Xie W, Jenkinson M, Namburete AIL. Subcortical Segmentation of the Fetal Brain in 3D Ultrasound using Deep Learning. Neuroimage 2022; 254:119117. [PMID: 35331871 DOI: 10.1016/j.neuroimage.2022.119117] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/25/2022] [Accepted: 03/17/2022] [Indexed: 12/24/2022] Open
Abstract
The quantification of subcortical volume development from 3D fetal ultrasound can provide important diagnostic information during pregnancy monitoring. However, manual segmentation of subcortical structures in ultrasound volumes is time-consuming and challenging due to low soft tissue contrast, speckle and shadowing artifacts. For this reason, we developed a convolutional neural network (CNN) for the automated segmentation of the choroid plexus (CP), lateral posterior ventricle horns (LPVH), cavum septum pellucidum et vergae (CSPV), and cerebellum (CB) from 3D ultrasound. As ground-truth labels are scarce and expensive to obtain, we applied few-shot learning, in which only a small number of manual annotations (n = 9) are used to train a CNN. We compared training a CNN with only a few individually annotated volumes versus many weakly labelled volumes obtained from atlas-based segmentations. This showed that segmentation performance close to intra-observer variability can be obtained with only a handful of manual annotations. Finally, the trained models were applied to a large number (n = 278) of ultrasound image volumes of a diverse, healthy population, obtaining novel US-specific growth curves of the respective structures during the second trimester of gestation.
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Affiliation(s)
- Linde S Hesse
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom.
| | - Moska Aliasi
- Department of Obstetrics and Fetal Medicine, Leiden University Medical Center, The Netherlands
| | - Felipe Moser
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - theINTERGROWTH-Twenty First Consortium
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom; Department of Obstetrics and Fetal Medicine, Leiden University Medical Center, The Netherlands; Visual Geometry Group, Department of Engineering Science, University of Oxford, United Kingdom; Wellcome center for Integrative NeuroImaging, FMRIB, University of Oxford, United Kingdom; Australian Institute for Machine Learning (AIML), Australia; South Australian Health and Medical Research Institute (SAHMRI), Australia
| | - Monique C Haak
- Department of Obstetrics and Fetal Medicine, Leiden University Medical Center, The Netherlands
| | - Weidi Xie
- Visual Geometry Group, Department of Engineering Science, University of Oxford, United Kingdom
| | - Mark Jenkinson
- Wellcome center for Integrative NeuroImaging, FMRIB, University of Oxford, United Kingdom; Australian Institute for Machine Learning (AIML), Australia; South Australian Health and Medical Research Institute (SAHMRI), Australia
| | - Ana I L Namburete
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
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Can a Difference in Gestational Age According to Biparietal Diameter and Abdominal Circumference Predict Intrapartum Placental Abruption? J Clin Med 2021; 10:jcm10112413. [PMID: 34072409 PMCID: PMC8199074 DOI: 10.3390/jcm10112413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/15/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to investigate whether a difference in gestational age according to biparietal diameter (BPD) and abdominal circumference (AC) could be a clinically useful predictor of placental abruption during the intrapartum period. This retrospective cohort study was based on singletons who were delivered after 32 + 0 weeks between July 2015 and July 2020. We only included cases with at least two antepartum sonographies available within 4 weeks of delivery (n = 2790). We divided the study population into two groups according to the presence or absence of placental abruption and compared the clinical variables. The incidence of placental abruption was 2.0% (56/2790) and was associated with an older maternal age, a higher rate of preeclampsia, and being small for the gestational age. A difference of >2 weeks in gestational age according to BPD and AC occurred at a higher rate in the placental abruption group compared to the no abruption group (>2 weeks, 21.4% (12/56) vs. 7.5% (205/2734), p < 0.001; >3 weeks, 12.5% (7/56) vs. 2.0% (56/2734), p < 0.001). Logistic regression analysis revealed that the differences of >2 weeks and >3 weeks were both independent risk factors for placental abruption (odds ratio (OR) (95% confidence interval), 2.289 (1.140-4.600) and 3.918 (1.517-9.771), respectively) after adjusting for maternal age, preeclampsia, and small for gestational age births. We identified that a difference in gestational age of >2 weeks between BPD and AC could be an independent predictor of placental abruption.
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