title: Screening of Congenital Heart Diseases by Three-Dimensional Ultrasound Using Spatiotemporal Image Correlation: Influence of Professional Experience.
abstract: OBJECTIVE
  To evaluate the feasibility of the use of spatiotemporal image correlation (STIC) as a screening program for congenital heart disease and the influence of professional experience in those examinations.
  
  
  METHODS
  This prospective cross-sectional study included 64 pregnant women at gestational age between 20 and 34 weeks, and 12 physician participants who were divided into two groups: group 1-"STIC specialist"; and group 2-"STIC nonspecialist." Volumes were analyzed to obtain the five axial views for optimal fetal heart screening: abdominal situs, four-chamber view (4CV), outflow tract views (OTV), and three vessels and trachea view (3VT). The chi-square test (χ(2) ) was used to compare the group's results and kappa coefficient to evaluate inter- and intra-observer reproducibility.
  
  
  RESULTS
  Spatiotemporal image correlation volume acquisition was successful in 97.3% of cases in which it was attempted (group 1: 100%; group 2:95%). A total of 197 STIC volumes were used in this study. In 71%, it was possible to demonstrate 4CV and OTV (group 1:88.9%; group 2:58.6%). 4CV, OTV, and 3VT were visualized in 55.3% of the volume dataset (group 1:74.1% and group 2:42.2%). In 49% of volumes, all five views for optimal fetal heart screening were seen (group 1:67%; group 2: 36%). A good inter-observer agreement was found in all cardiac views and a good intra-observer agreement in most of views except in OTV.
  
  
  CONCLUSIONS
  We believe that STIC can be used as a tool to improve the cardiac screening examination of the fetus. Professional experience was the most important influence in the image quality of the STIC volume.
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Juliana Y
authors.initials: JY
authors.lastname: Novaes
authors.affiliation: Discipline of Cardiology, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Marina M
authors.initials: MM
authors.lastname: Zamith
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Enoch Q de Sá
authors.initials: EQ
authors.lastname: Barreto
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Fernanda S B
authors.initials: FS
authors.lastname: Barros
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Antonio F
authors.initials: AF
authors.lastname: Moron
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: congenital heart disease; experience; screening; spatiotemporal image correlation; three-dimensional ultrasound