Abnormal spleen enlargement (splenomegaly) is regarded as a clinical indicator for a range of conditions, including liver disease, cancer and blood diseases. While spleen length measured from ultrasound images is a commonly used surrogate for spleen size, spleen volume remains the gold standard metric for assessing splenomegaly and the severity of related clinical conditions. Computed tomography is the main imaging modality for measuring spleen volume, but it is less accessible in areas where there is a high prevalence of splenomegaly (e.g., the Global South). Our objective was to enable automated spleen volume measurement from 2D cross-sectional segmentations, which can be obtained from ultrasound imaging. In this study, we describe a variational autoencoder-based framework to measure spleen volume from single- or dual-view 2D spleen segmentations. We propose and evaluate three volume estimation methods within this framework. We also demonstrate how 95% confidence intervals of volume estimates can be produced to make our method more clinically useful. Our best model achieved mean relative volume accuracies of 86.62% and 92.58% for single- and dual-view segmentations, respectively, surpassing the performance of the clinical standard approach of linear regression using manual measurements and a comparative deep learning-based 2D-3D reconstruction-based approach. The proposed spleen volume estimation framework can be integrated into standard clinical workflows which currently use 2D ultrasound images to measure spleen length. To the best of our knowledge, this is the first work to achieve direct 3D spleen volume estimation from 2D spleen segmentations.
Sickle Cell Disease (SCD) is one of the most common genetic diseases in the world. Splenomegaly (abnormal enlargement of the spleen) is frequent among children with SCD. If left untreated, splenomegaly can be life-threatening. The current workflow to measure spleen size includes palpation, possibly followed by manual length measurement in 2D ultrasound imaging. However, this manual measurement is dependent on operator expertise and is subject to intra- and inter-observer variability. We investigate the use of deep learning to perform automatic estimation of spleen length from ultrasound images. We investigate two types of approach, one segmentation-based and one based on direct length estimation, and compare the results against measurements made by human experts. Our best model (segmentation-based) achieved a percentage length error of 7.42%, which is approaching the level of inter-observer variability (5.47%-6.34%). To the best of our knowledge, this is the first attempt to measure spleen size in a fully automated way from ultrasound images.