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Validation of a built-in software in automatically reconstructing the tomographic images of the levator ani muscle

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Abstract

Introduction and hypothesis

Transperineal ultrasound (TPUS) is an effective tool for evaluating the integrity of the levator ani muscle (LAM). Several operating steps are required to obtain the standard multi-slice image of the LAM, which is experience dependent and time consuming. This study was aimed at evaluating the feasibility and reproducibility of the built-in software, Smart-pelvic™, in reconstructing standard tomographic images of LAM from 3D/4D TPUS volumes.

Methods

This study was conducted at a tertiary teaching hospital, enrolling women who underwent TPUS. Tomographic images of the LAM were automatically reconstructed by Smart-pelvicTM and rated by two experienced observers as standard or nonstandard. The anteroposterior diameter (APD) of the levator hiatus was also measured on the mid-sagittal plane of the automatically and manually reconstructed images. The APD measurements of each approach were compared using Bland–Altman plots, and interclass correlation coefficient (ICC) was used to evaluate intra- and inter-observer reproducibility. Meanwhile, the time taken for the reconstruction process of both methods was also recorded.

Results

The ultrasound volume of a total of 104 patients were included in this study. Using Smart-pelvicTM, the overall success rate of the tomographic image reconstruction was 98%. Regarding measurements of APD, the ICC between the automatic and manual reconstruction methods was 0.99 (0.98, 0.99). The average time taken for reconstruction per case was 2.65 ± 0.52 s and 22.08 ± 3.45 s, respectively.

Conclusions

Using Smart-pelvicTM to reconstruct tomographic images of LAM is feasible, and it can promote TPUS by reducing operator dependence and improving examination efficiency in a clinical setting.

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Abbreviations

AI:

Artificial intelligence

APD:

Anteroposterior diameter

CI:

Confidence interval

ICC:

Intraclass correlation coefficient

LAM:

Levator ani muscle

SP:

Symphysis pubis

TPUS:

Transperineal ultrasound

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Acknowledgement

The authors are grateful to the patients for participating in this study.

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Author notes

  1. Enze Qu and Shuangyu Wu contributed equally to this work and are co-first authors

Authors and Affiliations

  1. Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, China

    Enze Qu, Shuangyu Wu, Man Zhang, Zeping Huang, Zhijuan Zheng & Xinling Zhang

Authors
  1. Enze Qu
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  2. Shuangyu Wu
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  3. Man Zhang
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  4. Zeping Huang
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  5. Zhijuan Zheng
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Contributions

Enze Qu: project development, data analysis, manuscript writing; Shuangyu Wu: project development, data analysis, manuscript writing; Man Zhang: data collection, manuscript writing; Zeping Huang: data collection, manuscript revision; Zhijuan Zheng: data collection, manuscript revision; Xinling Zhang: project development, data collection, manuscript revision.

Corresponding author

Correspondence to Xinling Zhang.

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The authors received no financial or otherwise support from the manufacturer of the equipment and software used in this study.

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Qu, E., Wu, S., Zhang, M. et al. Validation of a built-in software in automatically reconstructing the tomographic images of the levator ani muscle. Int Urogynecol J 35, 175–181 (2024). https://doi.org/10.1007/s00192-023-05686-z

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  • DOI: https://doi.org/10.1007/s00192-023-05686-z

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