Developing and Testing AI Models for Fetal Biometry and Amniotic Volume Assessment in Fetal Ultrasound Scans.

The DL models will be trained, validated, and tested on the retrospectively acquired data first. This data will consist of fetal US images gathered in the participating medical centers after patient-level anonymization. The ground truth for the models will consist of annotations made by radiologists and obstetricians for classification and segmentation purposes. The DL models will be trained to perform the following tasks:

• Detection of the following standard planes as described in the ISUOG guidelines: transthalamic, transventricular, transcerebellar, abdominal, and femoral planes on video loops.
• Image quality scoring according to the ISUOG guidelines of the transthalamic, abdominal and femoral planes.
• Fetal cranium, abdomen, and femur segmentation to measure HC, BPD AC, and FL.
• Detection of AF pockets.
• Segmentation of AF pockets and extraction of pockets depth in order to evaluate the SDP measurement

Physicians will be asked to save additional images and video loops additional to their routine screening in the prospective examinations:

• Eight images: transthalamic, abdominal, and femoral standard planes with and without calipers, SDP with and without calipers.
• Four video loops up to five seconds each:

• A cephalic loop encompassing the transcerebellar, transthalamic, and transventricular planes.
• An abdominal loop going from the four-chamber view of the heart to a cross-section of the kidneys and back.
• A femoral loop with the probe parallel to the sagittal axis of the femur sweeping from side to side.
• A whole amniotic cavity loop, with the probe perpendicular to the ground applying as little pressure as possible on the patient's abdomen, sweeping from the uterine fundus to the cervix, once or twice depending on the volume of the amniotic cavity.

The clinicians performing the exam in "real-time"(RT clinicians), the panel of experts, and the DL models will review the prospective examinations.

The SDP measurement extracted by the AF pocket detection and segmentation models will be directly compared to the value measured by the RT clinicians.

Then, the image quality of planes selected by the RT clinicians and the model will be scored by the panel of experts.

The segmentation task will be evaluated in a tripartite fashion: the model, the RT clinicians, and the panel will all segment the same images.

To assess inter-observer agreement, 10% of the images will be randomly selected and reviewed by two independent reviewers from the panel.

Inclusion criteria

• Single or multiple viable pregnancies with a gestational age of 14 weeks or more as dated on a first trimester US scan with the crown-rump length (CRL) measurement or grossly estimated from the last menstrual period (LMP).
• Routine programmed US scan.
• Patient's consent is obtained.
• Patient over 18 years old.

Exclusion criteria

• Emergency indication for the fetal ultrasound
• Major morphological malformations that do not allow proper measurement of the cranium, abdominal or lower limb, for example, anencephaly, omphalocele, lower limb phocomelia.
• Fetal death.