title: The feasibility of using 5D CNS software in obtaining standard fetal head measurements from volumes acquired by three-dimensional ultrasonography: comparison with two-dimensional ultrasound.
abstract: OBJECTIVE
  To evaluate the performance of a new software (5D CNS) developed to automatically recognize the axial planes of the fetal brain from three-dimensional volumes and to obtain the basic standard biometric measurements. The accuracy, reproducibility, and time required for analysis of 5D CNS were compared with that of two-dimensional (2D) ultrasound.
  
  
  METHODS
  This was a prospective study of 120 uncomplicated singleton pregnancies undergoing routine second trimester examination. For every pregnancy standard biometric measurements including biparietal diameter, head circumference, distal lateral ventricle width, transverse cerebellar diameter and cisterna magna width were obtained using 2D ultrasound and three-dimensional (3D) ultrasound with 5D CNS software. Reliability and agreement of the two techniques were evaluated using intraclass correlation coefficients (ICCs) and proportionate Bland-Altman plots were constructed. The time necessary to complete the measurements with either technique was compared and intraobserver and interobserver agreements of measurements calculated.
  
  
  RESULTS
  In 118/120 (98.3%), 5D CNS successfully reconstructed the axial diagnostic planes and calculated all the basic biometric head and brain measurements. The agreement between the two techniques was high for all the measurements considered (all ICCS > 0.920). The time necessary to measure the biometric variables considered was significantly shorter with 5D CNS (54 versus 115 s, p < 0.0001) than with 2D ultrasonography. No significant differences were found in 5D CNS repeated measurements obtained either by the same observer or by two independent observers.
  
  
  CONCLUSIONS
  5D CNS software allows us to obtain reliable biometric measurements of the fetal brain and to reduce the examination time. Its application may improve work-flow efficiency in ultrasonographic practices.
authors.affiliation: a Department of Obstetrics and Gynecology , Università Di Roma "Tor Vergata" , Roma , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rizzo
authors.affiliation: a Department of Obstetrics and Gynecology , Università Di Roma "Tor Vergata" , Roma , Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Aiello
authors.affiliation: a Department of Obstetrics and Gynecology , Università Di Roma "Tor Vergata" , Roma , Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Pietrolucci
authors.affiliation: a Department of Obstetrics and Gynecology , Università Di Roma "Tor Vergata" , Roma , Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Arduini
mesh_terms: D000293:Adolescent; D000328:Adult; D001699:Biometry; D001921:Brain / Q000000981:diagnostic imaging*; D002508:Cephalometry / Q000379:methods*; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D015203:Reproducibility of Results; D012984:Software; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: 3D ultrasound; Automatic measurement software; fetal biometry; fetal brain