Automated Fetal Biometry Assessment with Deep Ensembles using Sparse-Sampling of 2D Intrapartum Ultrasound Images

The International Society of Ultrasound advocates Intrapartum Ultrasound (US) Imaging in Obstetrics and Gynecology (ISUOG) to monitor labour progression through changes in fetal head position. Two reliable ultrasound-derived parameters that are used to predict outcomes of instrumental vaginal delivery are the angle of progression (AoP) and head-symphysis distance (HSD). In this work, as part of the Intrapartum Ultrasounds Grand Challenge (IUGC) 2024, we propose an automated fetal biometry measurement pipeline to reduce intra- and inter-observer variability and improve measurement reliability. Our pipeline consists of three key tasks: (i) classification of standard planes (SP) from US videos, (ii) segmentation of fetal head and pubic symphysis from the detected SPs, and (iii) computation of the AoP and HSD from the segmented regions. We perform sparse sampling to mitigate class imbalances and reduce spurious correlations in task (i), and utilize ensemble-based deep learning methods for task (i) and (ii) to enhance generalizability under different US acquisition settings. Finally, to promote robustness in task iii) with respect to the structural fidelity of measurements, we retain the largest connected components and apply ellipse fitting to the segmentations. Our solution achieved ACC: 0.9452, F1: 0.9225, AUC: 0.983, MCC: 0.8361, DSC: 0.918, HD: 19.73, ASD: 5.71, $\Delta_{AoP}$: 8.90 and $\Delta_{HSD}$: 14.35 across an unseen hold-out set of 4 patients and 224 US frames. The results from the proposed automated pipeline can improve the understanding of labour arrest causes and guide the development of clinical risk stratification tools for efficient and effective prenatal care.

Geometric Transformation Uncertainty for Improving 3D Fetal Brain Pose Prediction from Freehand 2D Ultrasound Videos

Accurately localizing two-dimensional (2D) ultrasound (US) fetal brain images in the 3D brain, using minimal computational resources, is an important task for automated US analysis of fetal growth and development. We propose an uncertainty-aware deep learning model for automated 3D plane localization in 2D fetal brain images. Specifically, a multi-head network is trained to jointly regress 3D plane pose from 2D images in terms of different geometric transformations. The model explicitly learns to predict uncertainty to allocate higher weight to inputs with low variances across different transformations to improve performance. Our proposed method, QAERTS, demonstrates superior pose estimation accuracy than the state-of-the-art and most of the uncertainty-based approaches, leading to 9% improvement on plane angle (PA) for localization accuracy, and 8% on normalized cross-correlation (NCC) for sampled image quality. QAERTS also demonstrates efficiency, containing 5$\times$ fewer parameters than ensemble-based approach, making it advantageous in resource-constrained settings. In addition, QAERTS proves to be more robust to noise effects observed in freehand US scanning by leveraging rotational discontinuities and explicit output uncertainties.