Obstet Gynecol Sci.  2015 Jul;58(4):268-276. 10.5468/ogs.2015.58.4.268.

Feasibility of three-dimensional reconstruction and automated measurement of fetal long bones using 5D Long Bone

Affiliations
  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea. jaykwon@yuhs.ac
  • 2Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Samsung Medison Research and Development Center, Seoul, Korea.

Abstract


OBJECTIVE
To evaluate the feasibility of five-dimensional Long Bone (5D LB), a new technique that automatically archives, reconstructs images, and measures lengths of fetal long bones, to assess whether the direction of volume sweep influences fetal long bone measurements in three-dimensional (3D) ultrasound and 5D LB, and to compare measurements of fetal long bone lengths obtained with 5D LB and those obtained with conventional two-dimensional (2D) and manual 3D techniques.
METHODS
This prospective study included 39 singleton pregnancies at 26+0 to 32+0 weeks of gestation. Multiple pregnancies, fetuses with multiple congenital anomalies, and mothers with underlying medical diseases were excluded. Fetal long bones of the lower extremities-the femur, tibia, and fibula were measured by 2D and 3D ultrasound, and 5D LB, by an expert and non-expert examiner. First, we analyzed the 3D ultrasound and 5D LB data according to 2 different sweeping angles. We analyzed intra- and inter-observer variability and agreement between ultrasound techniques. Paired t-test, interclass correlation coefficient, and Bland-Altman plot and Passing-Bablok regression were used for statistical analysis.
RESULTS
There was no statistical difference between long bone measurements analyzed according to 2 different volume-sweeping angles by 3D ultrasound and 5D LB. Intra- and inter-observer variability were not significantly different among all 3 ultrasound techniques. Comparing 2D ultrasound and 5D LB, the interclass correlation coefficient for femur, tibia, and fibula was 0.91, 0.92, and 0.89, respectively.
CONCLUSION
5D LB is reproducible and comparable with conventional 2D and 3D ultrasound techniques for fetal long bone measurement.

Keyword

5D Long Bone; Fetal biometry; Fetal long bone; Three-dimensional ultrasound; Two-dimensional ultrasound

MeSH Terms

Female
Femur
Fetus
Fibula
Humans
Mothers
Observer Variation
Pregnancy
Pregnancy, Multiple
Prospective Studies
Tibia
Ultrasonography

Figure

  • Fig. 1 Three-dimensional ultrasound images showing the initial planes for three-dimensional volume acquisition of femur longitudinal-90 (A), femur longitudinal-45 (B), and the tibia and fibula (C).

  • Fig. 2 Long bone measurement by five-dimensional Long Bone. The three-dimensional volume data were displayed in the multiplanar mode (A) and the five-dimensional Long Bone set key was pressed. The system reconstructed a three-dimensional image of the long bones and the length of the long bone was measured automatically (B).

  • Fig. 3 Bland-Altman plots showing variability in long bone lengths measurements using two-dimensional ultrasound (2D-US) and three-dimensional ultrasound (3D-US) (A-C), 2D-US, and five-dimensional Long Bone (5D LB) (D-F). SD, standard deviation.


Reference

1. Schramm T, Gloning KP, Minderer S, Tutschek B. 3D ultrasound in fetal spina bifida. Ultraschall Med. 2008; 29(Suppl 5):289–290. PMID: 19085742.
Article
2. Bromley B, Shipp TD, Benacerraf B. Assessment of the third-trimester fetus using 3-dimensional volumes: a pilot study. J Clin Ultrasound. 2007; 35:231–237. PMID: 17444536.
Article
3. Krakow D, Williams J 3rd, Poehl M, Rimoin DL, Platt LD. Use of three-dimensional ultrasound imaging in the diagnosis of prenatal-onset skeletal dysplasias. Ultrasound Obstet Gynecol. 2003; 21:467–472. PMID: 12768559.
Article
4. Verwoerd-Dikkeboom CM, Koning AH, Hop WC, Rousian M, Van Der Spek PJ, Exalto N, et al. Reliability of three-dimensional sonographic measurements in early pregnancy using virtual reality. Ultrasound Obstet Gynecol. 2008; 32:910–916. PMID: 18792418.
Article
5. Benacerraf BR, Shipp TD, Bromley B. Three-dimensional US of the fetus: volume imaging. Radiology. 2006; 238:988–996. PMID: 16424249.
Article
6. Tonni G, Grisolia G, Sepulveda W. Second trimester fetal neurosonography: reconstructing cerebral midline anatomy and anomalies using a novel three-dimensional ultrasound technique. Prenat Diagn. 2014; 34:75–83. PMID: 24142501.
Article
7. Liu X, Yu J, Wang Y, Chen P. Automatic localization of the fetal cerebellum on 3D ultrasound volumes. Med Phys. 2013; 40:112902. PMID: 24320469.
Article
8. Abuhamad A, Falkensammer P, Reichartseder F, Zhao Y. Automated retrieval of standard diagnostic fetal cardiac ultrasound planes in the second trimester of pregnancy: a prospective evaluation of software. Ultrasound Obstet Gynecol. 2008; 31:30–36. PMID: 18098347.
Article
9. Xiong Y, Liu T, Wu Y, Xu JF, Ting YH, Yeung Leung T, et al. Comparison of real-time three-dimensional echocardiography and spatiotemporal image correlation in assessment of fetal interventricular septum. J Matern Fetal Neonatal Med. 2012; 25:2333–2338. PMID: 22642553.
Article
10. Acar P, Battle L, Dulac Y, Peyre M, Dubourdieu H, Hascoet S, et al. Real-time three-dimensional foetal echocardiography using a new transabdominal xMATRIX array transducer. Arch Cardiovasc Dis. 2014; 107:4–9. PMID: 24364911.
Article
11. Cho HY, Kwon JY, Kim YH, Lee KH, Kim J, Kim SY, et al. Comparison of nuchal translucency measurements obtained using Volume NT(TM) and two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2012; 39:175–180. PMID: 21412924.
Article
12. Lee MY, Won HS, Jeong BD, Hyun MK, Lee HY, Shim JY, et al. Measurement of intracranial translucency using three-dimensional ultrasound and Volume IT(TM). Prenat Diagn. 2012; 32:472–475. PMID: 22504717.
13. Zador IE, Salari V, Chik L, Sokol RJ. Ultrasound measurement of the fetal head: computer versus operator. Ultrasound Obstet Gynecol. 1991; 1:208–211. PMID: 12797074.
Article
14. Thomas JG, Jeanty P, Peters RA 2nd, Parrish EA Jr. Automatic measurements of fetal long bones. A feasibility study. J Ultrasound Med. 1991; 10:381–385. PMID: 1870182.
Article
15. Rahmatullah B, Besar R. Analysis of semi-automated method for femur length measurement from foetal ultrasound. J Med Eng Technol. 2009; 33:417–425. PMID: 19637083.
Article
16. Chalana V, Winter TC 3rd, Cyr DR, Haynor DR, Kim Y. Automatic fetal head measurements from sonographic images. Acad Radiol. 1996; 3:628–635. PMID: 8796726.
Article
17. Schoenfeld A, Goverman J, Weiss DM, Meizner I. Transducer user syndrome: an occupational hazard of the ultrasonographer. Eur J Ultrasound. 1999; 10:41–45. PMID: 10502638.
Article
18. Mercer RB, Marcella CP, Carney DK, McDonald RW. Occupational health hazards to the ultrasonographer and their possible prevention. J Am Soc Echocardiogr. 1997; 10:363–366. PMID: 9168359.
Article
19. Hull AD, Pretorius DH, Lev-Toaff A, Budorick NE, Salerno CC, Johnson MM, et al. Artifacts and the visualization of fetal distal extremities using three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2000; 16:341–344. PMID: 11169310.
Article
20. Matrone G, Quaglia F, Magenes G. Simulating ultrasound fields for 2D phased-array probes design optimization. Conf Proc IEEE Eng Med Biol Soc. 2011; 2011:8507–8510. PMID: 22256323.
Article
21. Wygant IO, Zhuang X, Yeh DT, Oralkan O, Sanli Ergun A, Karaman M, et al. Integration of 2D CMUT arrays with front-end electronics for volumetric ultrasound imaging. IEEE Trans Ultrason Ferroelectr Freq Control. 2008; 55:327–342. PMID: 18334340.
Article
22. Wygant IO, Jamal NS, Lee HJ, Nikoozadeh A, Oralkan O, Karaman M, et al. An integrated circuit with transmit beamforming flip-chip bonded to a 2-D CMUT array for 3-D ultrasound imaging. IEEE Trans Ultrason Ferroelectr Freq Control. 2009; 56:2145–2156. PMID: 19942502.
Article
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