Transvaginal ultrasound (TVUS) is widely used in infertility treatment. The size and shape of the ovary and follicles must be measured manually for assessing their physiological status by sonographers. However, this process is extremely time-consuming and operator-dependent. In this study, we propose a novel composite network, namely CR-Unet, to simultaneously segment the ovary and follicles in TVUS. The CR-Unet incorporates the spatial recurrent neural network (RNN) into a plain U-Net. It can effectively learn multi-scale and long-range spatial contexts to combat the challenges of this task, such as the poor image quality, low contrast, boundary ambiguity, and complex anatomy shapes. We further adopt deep supervision strategy to make model training more effective and efficient. In addition, self-supervision is employed to iteratively refine the segmentation results. Experiments on 3204 TVUS images from 219 patients demonstrate the proposed method achieved the best segmentation performance compared to other state-of-the-art methods for both the ovary and follicles, with a Dice Similarity Coefficient (DSC) of 0.912 and 0.858, respectively.

Quality control/assessment of ultrasound (US) images is an essential step in clinical diagnosis. This process is usually done manually, suffering from some drawbacks, such as dependence on operator's experience and extensive labors, as well as high inter- and intra-observer variation. Automatic quality assessment of US images is therefore highly desirable. Fetal US cardiac four-chamber plane (CFP) is one of the most commonly used cardiac views, which was used in the diagnosis of heart anomalies in the early 1980s. In this paper, we propose a generic deep learning framework for automatic quality control of fetal US CFPs. The proposed framework consists of three networks: (1) a basic CNN (B-CNN), roughly classifying four-chamber views from the raw data; (2) a deeper CNN (D-CNN), determining the gain and zoom of the target images in a multi-task learning manner; and (3) the aggregated residual visual block net (ARVBNet), detecting the key anatomical structures on a plane. Based on the output of the three networks, overall quantitative score of each CFP is obtained, so as to achieve fully automatic quality control. Experiments on a fetal US dataset demonstrated our proposed method achieved a highest mean average precision (mAP) of 93.52% at a fast speed of 101 frames per second (FPS). In order to demonstrate the adaptability and generalization capacity, the proposed detection network (i.e., ARVBNet) has also been validated on the PASCAL VOC dataset, obtaining a highest mAP of 81.2% when input size is approximately 300 × 300.

The ultrasound (US) screening of the infant hip is vital for the early diagnosis of developmental dysplasia of the hip (DDH). The US diagnosis of DDH refers to measuring alpha and beta angles that quantify hip joint development. These two angles are calculated from key anatomical landmarks and structures of the hip. However, this measurement process is not trivial for sonographers and usually requires a thorough understanding of complex anatomical structures. In this study, we propose a multi-task framework to learn the relationships among landmarks and structures jointly and automatically evaluate DDH. Our multi-task networks are equipped with three novel modules. Firstly, we adopt Mask R-CNN as the basic framework to detect and segment key anatomical structures and add one landmark detection branch to form a new multi-task framework. Secondly, we propose a novel shape similarity loss to refine the incomplete anatomical structure prediction robustly and accurately. Thirdly, we further incorporate the landmark-structure consistent prior to ensure the consistency of the bony rim estimated from the segmented structure and the detected landmark. In our experiments, 1231 US images of the infant hip from 632 patients are collected, of which 247 images from 126 patients are tested. The average errors in alpha and beta angles are 2.221 ${}^{\circ }$ and 2.899 ${}^{\circ }$ . About 93% and 85% estimates of alpha and beta angles have errors less than 5 degrees, respectively. Experimental results demonstrate that the proposed method can accurately and robustly realize the automatic evaluation of DDH, showing great potential for clinical application.