Aoyama Rina, Komatsu Masaaki, Harada Naoaki, Komatsu Reina, Sakai Akira, Takeda Katsuji, Teraya Naoki, Asada Ken, Kaneko Syuzo, Iwamoto Kazuki, Matsuoka Ryu, Sekizawa Akihiko, Hamamoto Ryuji
Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Department of Obstetrics and Gynecology, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
Bioengineering (Basel). 2024 Dec 12;11(12):1256. doi: 10.3390/bioengineering11121256.
The three-vessel view (3VV) is a standardized transverse scanning plane used in fetal cardiac ultrasound screening to measure the absolute and relative diameters of the pulmonary artery (PA), ascending aorta (Ao), and superior vena cava, as required. The PA/Ao ratio is used to support the diagnosis of congenital heart disease (CHD). However, vascular diameters are measured manually by examiners, which causes intra- and interobserver variability in clinical practice. In the present study, we aimed to develop an artificial intelligence-based method for the standardized and quantitative evaluation of 3VV. In total, 315 cases and 20 examiners were included in this study. We used the object-detection software YOLOv7 for the automated extraction of 3VV images and compared three segmentation algorithms: DeepLabv3+, UNet3+, and SegFormer. Using the PA/Ao ratios based on vascular segmentation, YOLOv7 plus UNet3+ yielded the most appropriate classification for normal fetuses and those with CHD. Furthermore, YOLOv7 plus UNet3+ achieved an arithmetic mean value of 0.883 for the area under the receiver operating characteristic curve, which was higher than 0.749 for residents and 0.808 for fellows. Our automated method may support unskilled examiners in performing quantitative and objective assessments of 3VV images during fetal cardiac ultrasound screening.
三血管视图(3VV)是胎儿心脏超声筛查中使用的标准化横向扫描平面,用于根据需要测量肺动脉(PA)、升主动脉(Ao)和上腔静脉的绝对和相对直径。PA/Ao比值用于辅助先天性心脏病(CHD)的诊断。然而,血管直径由检查者手动测量,这在临床实践中导致了观察者内和观察者间的变异性。在本研究中,我们旨在开发一种基于人工智能的方法,用于对3VV进行标准化和定量评估。本研究共纳入315例病例和20名检查者。我们使用目标检测软件YOLOv7自动提取3VV图像,并比较了三种分割算法:DeepLabv3+、UNet3+和SegFormer。基于血管分割的PA/Ao比值,YOLOv7加UNet3+对正常胎儿和患有CHD的胎儿产生了最合适的分类。此外,YOLOv7加UNet3+的受试者工作特征曲线下面积的算术平均值为0.883,高于住院医师的0.749和研究员的0.808。我们的自动化方法可能有助于非专业检查者在胎儿心脏超声筛查期间对3VV图像进行定量和客观评估。