A novel approach to aortic intima-media thickness quantification from fetal ultrasound images

Intrauterine fetal growth restriction (IUGR) is linked to increased cardiovascular mortality during adulthood. IUGR induces an increase in aortic intima-media thickness (aIMT) which can be detected from fetal ultrasound images, potentially improving IUGR assessment and thus cardiovascular risk management. Unfortunately this measurement currently relies on tedious and error-prone manual tracing. The aims of this study were to develop and test a novel near-automated technique for aIMT quantification from ultrasound images. The proposed technique uses a level-set method (with a functional relying on a distance-based term) to identify blood-intima and media-adventitia interfaces as a basis for aIMT estimation. This approach was tested on images acquired from 10 subjects, and automatically extracted aIMT values were compared to reference values manually obtained by two interpreters. Results indicate that the accuracy of the proposed technique is close to that of manual tracing, suggesting that it could be adopted as a basis for fast and reliable near-automated aIMT estimation.