How to Acquire Cardiac Volumes for Sonographic Examination of the Fetal Heart

Yeo, Lami; Romero, Roberto

doi:10.7863/ultra.16.01082

Cited by 18 publications

(10 citation statements)

References 113 publications

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“…Adequate education and training of sonologists is an essential step to assure that: 1) STIC volumes are appropriately acquired in the clinical setting and are of high quality [17,58,62,63]; 2) determination of the appropriateness of such volumes occurs (i.e. STICLoop™); and 3) there is maximal utilization of the features of the FINE method (e.g.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

Veronese¹,

Bogana²,

Cerutti³

et al. 2016

Fetal Diagn Ther

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Objective: To evaluate the performance of Fetal Intelligent Navigation Echocardiography (FINE) applied to spatiotemporal image correlation (STIC) volume datasets of the normal fetal heart in generating standard fetal echocardiography views. Methods: In this prospective cohort study of patients with normal fetal hearts (19-30 gestational weeks), one or more STIC volume datasets were obtained of the apical four-chamber view. Each STIC volume successfully obtained was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates for standard fetal echocardiography views using diagnostic planes and/or Virtual Intelligent Sonographer Assistance (VIS-Assistance®) were calculated. Results: One or more STIC volumes (total n = 463) were obtained from 246 patients. A single STIC volume per patient was analyzed using the FINE method. In normal cases, FINE was able to generate nine fetal echocardiography views using: (1) diagnostic planes in 76-100% of the cases, (2) VIS-Assistance® in 96-100% of the cases, and (3) a combination of diagnostic planes and/or VIS-Assistance® in 96-100% of the cases. Conclusion: FINE applied to STIC volumes can successfully generate nine standard fetal echocardiography views in 96-100% of cases in the 2nd and 3rd trimesters. This suggests that the technology can be used as a method of screening for congenital heart disease.

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Section: Discussionmentioning

confidence: 99%

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

Veronese¹,

Bogana²,

Cerutti³

et al. 2016

Fetal Diagn Ther

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“…Such training occurred in a 2-day period and included: 1) attending didactic lectures on FINE; and 2) review of 16 previously acquired STIC volume datasets of normal fetal hearts using the FINE method. Specifically, the following features of FINE were reviewed during the training period (Table 1): 55,76,77,79 1) intelligent navigation technology; 2) STICLoop ™ and STICLoop criteria; 3) Anatomic Box® (learning how to identify and mark anatomical structures of the fetal heart); 4) diagnostic planes; 5) automatic labeling and its features; 6) Virtual Intelligent Sonographer Assistance (VIS-Assistance®) and its advantages in providing additional information, as well as how to perform double and triple VIS-Assistance; 80 and 7) intelligent and marking alerts. Moreover, the same investigator was provided a written manual on FINE and underwent a practical session on how to technically use the system (e.g.…”

Section: Methodsmentioning

confidence: 99%

Fetal Intelligent Navigation Echocardiography (FINE) Detects 98% of Congenital Heart Disease

Yeo

Luewan

Romero

2018

J of Ultrasound Medicine

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Objective Fetal Intelligent Navigation Echocardiography (FINE) is a novel method that automatically generates and displays nine standard fetal echocardiography views in normal hearts by applying intelligent navigation technology to spatiotemporal image correlation (STIC) volume datasets. The main objective was to determine the sensitivity and specificity of FINE in the prenatal detection of congenital heart disease (CHD). Methods A case-control study was conducted in 50 fetuses with a broad spectrum of CHD (cases) and 100 fetuses with normal hearts (controls) in the second and third trimesters. Using four-dimensional ultrasound with STIC technology, volume datasets were acquired. After all identifying information was removed, the datasets were randomly distributed to a different investigator for analysis using FINE. The sensitivity and specificity for the prenatal detection of CHD, as well as positive and negative likelihood ratios (LR) were determined. Results The diagnostic performance of FINE for the prenatal detection of CHD was: sensitivity 98% (49/50), specificity 93% (93/100), positive LR of 14, and negative LR of 0.02. Among cases with confirmed CHD, the diagnosis based upon FINE completely matched the final diagnosis in 74% (37/50), minor discrepancies were seen in 12% (6/50), and major discrepancies were seen in 14% (7/50). Conclusions We present for the first time the sensitivity and specificity of the FINE method in fetuses with normal hearts and CHD in the second and third trimesters. Since FINE identifies a broad spectrum of CHD with 98% sensitivity, this method could be used prenatally to screen for and diagnose CHD.

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“…We noted fetal growth restriction (estimated fetal weight <5 th percentile) and a decreased amniotic fluid index of 7.9 cm. Yet, despite the advanced gestational age, amniotic fluid volume, and extreme obesity, we immediately recognized that conditions were appropriate to acquire STIC volume datasets [27,28]. For example, the fetal spine was located at the 6-o’clock position, there was minimal shadowing of the four-chamber view and upper mediastinum, as well as absent fetal breathing and gross movements [28].…”

Section: Clinical Casementioning

confidence: 99%

“…Yet, despite the advanced gestational age, amniotic fluid volume, and extreme obesity, we immediately recognized that conditions were appropriate to acquire STIC volume datasets [27,28]. For example, the fetal spine was located at the 6-o’clock position, there was minimal shadowing of the four-chamber view and upper mediastinum, as well as absent fetal breathing and gross movements [28]. Therefore, within 6 minutes of beginning the ultrasound examination, multiple STIC volume datasets of the fetal heart were acquired from the apical four-chamber view by transverse sweeps through the fetal chest.…”

Section: Clinical Casementioning

confidence: 99%

“…There is a growing body of evidence suggesting that four-dimensional (4D) sonography with spatiotemporal image correlation (STIC) can facilitate examination of the fetal heart [12–26]. STIC technology allows acquisition of a fetal cardiac volume data set and displays a cine loop of a complete single cardiac cycle in motion [13–15,27,28]. Such volume datasets allow sonologists to extract and display cardiac planes in any orientation.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal Diagnosis of Dextrocardia with Complex Congenital Heart Disease Using Fetal Intelligent Navigation Echocardiography (FINE) and a Literature Review

Yeo¹,

Luewan²,

Markush³

et al. 2017

Fetal Diagn Ther

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Fetal dextrocardia is a type of cardiac malposition where the major axis from base to apex points to the right side. This condition is usually associated with a wide spectrum of complex cardiac defects. As a result, dextrocardia is conceptually difficult to understand and diagnose on prenatal ultrasound. The advantage of four-dimensional sonography with spatiotemporal image correlation (STIC) is that this modality can facilitate fetal cardiac examination. A novel method known as fetal intelligent navigation echocardiography (FINE) allows automatic generation of nine standard fetal echocardiography views in normal hearts by applying intelligent navigation technology to STIC volume datasets. In fetuses with congenital heart disease, FINE is also able to demonstrate abnormal cardiac anatomy and relationships when there is normal cardiac axis and position. However, this technology has never been applied to cases of cardiac malposition. We report herein for the first time, a case of fetal dextrocardia and situs solitus with complex congenital heart disease in which the FINE method was invaluable in diagnosing multiple abnormalities and defining complex anatomic relationships. We also review the literature on prenatal sonographic diagnosis of dextrocardia (with an emphasis on situs solitus), as well as tricuspid atresia with its associated cardiac features.

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How to Acquire Cardiac Volumes for Sonographic Examination of the Fetal Heart

Cited by 18 publications

References 113 publications

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

Fetal Intelligent Navigation Echocardiography (FINE) Detects 98% of Congenital Heart Disease

Prenatal Diagnosis of Dextrocardia with Complex Congenital Heart Disease Using Fetal Intelligent Navigation Echocardiography (FINE) and a Literature Review

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