Feasibility of 4D-Spatio Temporal Image Correlation (STIC) in the Comprehensive Assessment of the Fetal Heart Using FetalHQ®

Abstract

Fetal Heart Quantification (FetalHQ®) is a novel speckle tracking software that permits the study of global and regional ventricular shape and function from a 2D four-chamber-view loop. The 4D-Spatio Temporal Image Correlation (STIC) modality enables the offline analysis of optimized and perfectly aligned cardiac planes. We aimed to evaluate the feasibility and reproducibility of 4D-STIC speckle tracking echocardiography (STE) using FetalHQ® and to compare it to 2D STE. We conducted a prospective study including 31 low-risk singleton pregnancies between 20 and 40 weeks of gestation. Four-chamber view volumes and 2D clips were acquired with an apex pointing at 45° and with a frame rate higher than 60 Hz. Morphometric and functional echocardiography was performed by FetalHQ®. Intra- and interobserver reproducibility were evaluated by the intraclass correlation coefficient (ICC). Our results showed excellent reproducibility (ICC > 0.900) for morphometric evaluation (biventricular area, longitudinal and transverse diameters). Reproducibility was also good (ICC > 0.800) for functional evaluation (biventricular strain, Fractional Area Change, left ventricle volumes, ejection fraction and cardiac output). On the contrary, the study of the sphericity index and shortening fraction of the different ventricular segments showed lower reproducibility (ICC < 0.800). To conclude, 4D-STIC is feasible, reproducible and comparable to 2D echocardiography for the assessment of cardiac morphometry and function.

Evaluation of Fetal Cardiac Geometry and Contractility in Gestational Diabetes Mellitus by Two-Dimensional Speckle-Tracking Technology

“…In this study, the intra-rater and inter-rater reliability for LV global measurements ranged from good to excellent, but RV GLS and FAC had poor reliability. Nogué et al reported poor reliability for the 24-segment SI and FS at a 60 Hz threshold, especially for the basal segments [ 47 ]. In our study, reliability was moderate to good for EDD and SI for both ventricles, but the FS had poor repeatability for the RV, especially for segment 1.…”

Fetal cardiac function evaluation: A review

“…47 The use of four dimensional fetal echocardiography (4D-STIC) permits good resolution offline analysis and the possibility to modify the angle of insonation, the cardiac plane, and the frame for evaluation. 44,48,49…”

How automated techniques ease functional assessment of the fetal heart: applicability of two-dimensional speckle-tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®

“…The knowledge of fetal cardiac function assessment as well as fetal echocardiography itself has advanced dramatically in recent decades [1][2][3][4][5]. With its different modalities, fetal echocardiography has become indispensable for cardiac function assessment [3,6].…”

“…With its different modalities, fetal echocardiography has become indispensable for cardiac function assessment [3,6]. With the implementation of fetal echocardiography in clinical routine, two foci arose: the detection of structural congenital cardiac defects (CHD) and subsequently the assessment of fetal cardiac morphometry and function [2,[7][8][9][10]. Fetal echocardiography is crucial for indirect evaluation of fetal ventricular size and functional parameters since the fetal heart cannot be measured directly in utero [11].…”