Prospective evaluation of the fetal heart using Fetal Intelligent Navigation Echocardiography (FINE).
OBJECTIVE
To evaluate prospectively the performance of Fetal Intelligent Navigation Echocardiography (FINE) applied to spatiotemporal image correlation (STIC) volume datasets of the normal fetal heart.


METHODS
In all women between 19 and 30 weeks' gestation with a normal fetal heart, an attempt was made to acquire STIC volume datasets of the apical four-chamber view if the following criteria were met: (1) fetal spine located between 5- and 7-o'clock positions; (2) minimal or absent shadowing (including a clearly visible transverse aortic arch); (3) absence of fetal breathing, hiccups, or movement; and (4) adequate image quality. Each STIC volume successfully acquired was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates of fetal echocardiography views using diagnostic planes and/or Virtual Intelligent Sonographer Assistance (VIS-Assistance®) were calculated.


RESULTS
One or more STIC volumes (365 in total) were obtained successfully in 72.5% (150/207) of women undergoing ultrasound examination. Of the 365 volumes evaluated by STICLoop, 351 (96.2%) were considered to be appropriate. From the 351 STIC volumes, only one STIC volume per patient (n = 150) was analyzed using the FINE method, and consequently nine fetal echocardiography views were generated in 76-100% of cases using diagnostic planes only, in 98-100% of cases using VIS-Assistance only, and in 98-100% of cases when using a combination of diagnostic planes and/or VIS-Assistance.


CONCLUSIONS
In women between 19 and 30 weeks' gestation with a normal fetal heart undergoing prospective sonographic examination, STIC volumes can be obtained successfully in 72.5% of cases. The FINE method can be applied to generate nine standard fetal echocardiography views in 98-100% of these cases using a combination of diagnostic planes and/or VIS-Assistance. This suggests that FINE could be implemented in fetal cardiac screening programs. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.
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M
Garcia
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.|Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
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L
Yeo
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.|Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.|Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
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R
Romero
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.
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D
Haggerty
Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
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I
Giardina
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.|Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
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SS
Hassan
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.|Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
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T
Chaiworapongsa
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.|Detroit, MI, USA.|Detroit Medical Center, Hutzel Women's Hospital, Detroit, MI, USA.|Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA.
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Hernandez-Andrade
D000328:Adult; D002306:Cardiac Volume; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
4D; STIC; Virtual Intelligent Sonographer Assistance; VIS-Assistance®; cardiac; fetal heart; prenatal diagnosis; spatiotemporal image correlation; ultrasound