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Feasibility of Automated 3-Dimensional Fetal Cardiac Screening in Routine Ultrasound Practice

Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.

Address correspondence to Lukas B. Uittenbogaard, MD, Department of Obstetrics and Gynecology, VU University Medical Center, Postbus 7057, NL-1007 MB, Amsterdam, the Netherlands. E-mail: lb.uittenbogaard{at}vumc.nl

Objective. The purpose of this study was to prospectively assess the clinical feasibility of an automated 3-dimensional (3D) software tool for extended basic cardiac screening in routine ultrasound practice. Methods. During the 2-month study period, all gravidas fitting our inclusion criteria were consecutively included. Cardiac 3D volumes were acquired within the time slot allocated for the usual 2-dimensional fetal examination. All volumes were assessed on their quality, based on display of the 4-chamber view, and on the ability to sufficiently display diagnostic cardiac planes (left ventricular outflow tract [LVOT], right ventricle outflow tract [RVOT], and stomach location) with Sonography-Based Volume Computer-Aided Diagnosis software (SonoVCAD; GE Healthcare, Milwaukee, WI). Results. Volume acquisition was successful in 107 of 126 cases (85%). For each sonographer, more than 70% of the acquired cardiac volumes were of high or sufficient quality. Separately analyzed, diagnostic planes of the LVOT, RVOT, and stomach location were visible in 62.1%, 81.6%, and 92.2%, respectively. An extended basic fetal cardiac examination based on retrieval of all diagnostic cardiac planes from a single volume using SonoVCAD could be performed in 46.6% of the cases. Conclusions. This study shows that cardiac volume acquisition can be incorporated in a routine ultrasound screening program without much difficulty. However, currently, SonoVCAD software still lacks the consistency to be clinically feasible for cardiac screening purposes. Further advances in ultrasound technology and familiarization with 3D ultrasound might improve its performance.

Key Words: automated sonography • fetal cardiac screening • fetal echocardiography • sonography-based volume computer-aided diagnosis • 3-dimensional ultrasound

Abbreviations: BMI, body mass index • CHD, congenital heart disease • 4CHV, 4-chamber view • GA, gestational age • LVOT, left ventricular outflow tract • RVOT, right ventricle outflow tract • SonoVCAD, Sonography-Based Volume Computer-Aided Diagnosis • 3D, 3-dimensional • 3DUS, 3-dimensional ultrasound • 3VV, 3-vessel view • TUI, tomographic ultrasound imaging • 2DUS, 2-dimensional ultrasound