Handheld ultrasound devices face usage limitations due to user inexperience and cannot benefit from supervised deep learning without extensive expert annotations. Moreover, the models trained on standard ultrasound device data are constrained by training data distribution and perform poorly when directly applied to handheld device data. In this study, we propose the Training-free Image Style Alignment (TISA) framework to align the style of handheld device data to those of standard devices. The proposed TISA can directly infer handheld device images without extra training and is suited for clinical applications. We show that TISA performs better and more stably in medical detection and segmentation tasks for handheld device data. We further validate TISA as the clinical model for automatic measurements of spinal curvature and carotid intima-media thickness. The automatic measurements agree well with manual measurements made by human experts and the measurement errors remain within clinically acceptable ranges. We demonstrate the potential for TISA to facilitate automatic diagnosis on handheld ultrasound devices and expedite their eventual widespread use.
Three-dimensional (3D) ultrasound imaging technique has been applied for scoliosis assessment, but current assessment method only uses coronal projection image and cannot illustrate the 3D deformity and vertebra rotation. The vertebra detection is essential to reveal 3D spine information, but the detection task is challenging due to complex data and limited annotations. We propose VertMatch, a two-step framework to detect vertebral structures in 3D ultrasound volume by utilizing unlabeled data in semi-supervised manner. The first step is to detect the possible positions of structures on transverse slice globally, and then the local patches are cropped based on detected positions. The second step is to distinguish whether the patches contain real vertebral structures and screen the predicted positions from the first step. VertMatch develops three novel components for semi-supervised learning: for position detection in the first step, (1) anatomical prior is used to screen pseudo labels generated from confidence threshold method; (2) multi-slice consistency is used to utilize more unlabeled data by inputting multiple adjacent slices; (3) for patch identification in the second step, the categories are rebalanced in each batch to solve imbalance problem. Experimental results demonstrate that VertMatch can detect vertebra accurately in ultrasound volume and outperforms state-of-the-art methods. VertMatch is also validated in clinical application on forty ultrasound scans, and it can be a promising approach for 3D assessment of scoliosis.