Abstract
Fetal ultrasound screening during pregnancy plays a vital role in the early detection of fetal malformations which have potential long-term health impacts. The level of skill required to diagnose such malformations from live ultrasound during examination is high and resources for screening are often limited. We present an interpretable, atlas-learning segmentation method for automatic diagnosis of Hypo-plastic Left Heart Syndrome (HLHS) from a single ‘4 Chamber Heart’ view image. We propose to extend the recently introduced Image-and-Spatial Transformer Networks (Atlas-ISTN) into a framework that enables sensitising atlas generation to disease. In this framework we can jointly learn image segmentation, registration, atlas construction and disease prediction while providing a maximum level of clinical interpretability compared to direct image classification methods. As a result our segmentation allows diagnoses competitive with expert-derived manual diagnosis and yields an AUC-ROC of 0.978 (1043 cases for training, 260 for validation and 325 for testing).
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Acknowledgements
We thank the volunteers and sonographers at St. Thomas’ Hospital London. The work of E.C.R. was supported by the Academy of Medical Sciences/the British Heart Foundation/the Government Department of Business, Energy and Industrial Strategy/the Wellcome Trust Springboard Award [SBF003/1116]. We also gratefully acknowledge financial support from the Wellcome Trust IEH 102431, EPSRC (EP/S022104/1, EP/S013687/1), EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z], the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London and supported by the NIHR Clinical Research Facility (CRF) at Guy’s and St Thomas’, and Nvidia GPU donations.
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Budd, S. et al. (2021). Detecting Hypo-plastic Left Heart Syndrome in Fetal Ultrasound via Disease-Specific Atlas Maps. In: de Bruijne, M., et al. Medical Image Computing and Computer Assisted Intervention – MICCAI 2021. MICCAI 2021. Lecture Notes in Computer Science(), vol 12907. Springer, Cham. https://doi.org/10.1007/978-3-030-87234-2_20
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