title: Evaluating Spatiotemporal Image Correlation Technology as a Tool for Training Nonexpert Sonographers to Perform Examinations of the Fetal Heart.
abstract: OBJECTIVE
  We aimed to evaluate the use of spatiotemporal image correlation (STIC) as a tool for training nonexpert examiners to perform screening examinations of the fetal heart by acquiring and examining STIC volumes according to a standardized questionnaire based on the 5 transverse planes of the fetal heart.
  
  
  METHODS
  We conducted a prospective study at 2 tertiary care centers. Two sonographers without formal training in fetal echocardiography received theoretical instruction on the 5 fetal echocardiographic transverse planes, as well as STIC technology. Only women with conditions allowing 4-dimensional STIC volume acquisitions (grayscale and Doppler) were included in the study. Acquired volumes were evaluated offline according to a standardized protocol that required the trainee to mark 30 specified structures on 5 required axial planes. Volumes were then reviewed by an expert examiner for quality of acquisition and correct identification of specified structures.
  
  
  RESULTS
  Ninety-six of 112 pregnant women examined entered the study. Patients had singleton pregnancies between 20 and 32 weeks' gestation. After an initial learning curve of 20 examinations, trainees succeeded in identifying 97% to 98% of structures, with a highly significant degree of agreement with the expert's analysis (P < .001). A median of 2 STIC volumes for each examination was necessary for maximal structure identification. Acquisition quality scores were high (8.6-8.7 of a maximal score of 10) and were found to correlate with identification rates (P = .017).
  
  
  CONCLUSIONS
  After an initial learning curve and under expert guidance, STIC is an excellent tool for trainees to master extended screening examinations of the fetal heart.
authors.affiliation: School of Women's and Children's Health, University of New South Wales Medicine, and Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia (H.A.); Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel (E.M., O.S.); and Ultrasound Center, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt Scopus, Jerusalem, Israel (S.C., S.Y.).
authors.forename: Hagai
authors.initials: H
authors.lastname: Avnet
authors.affiliation: School of Women's and Children's Health, University of New South Wales Medicine, and Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia (H.A.); Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel (E.M., O.S.); and Ultrasound Center, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt Scopus, Jerusalem, Israel (S.C., S.Y.).
authors.forename: Eyal
authors.initials: E
authors.lastname: Mazaaki
authors.affiliation: School of Women's and Children's Health, University of New South Wales Medicine, and Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia (H.A.); Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel (E.M., O.S.); and Ultrasound Center, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt Scopus, Jerusalem, Israel (S.C., S.Y.).
authors.forename: Ori
authors.initials: O
authors.lastname: Shen
authors.affiliation: School of Women's and Children's Health, University of New South Wales Medicine, and Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia (H.A.); Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel (E.M., O.S.); and Ultrasound Center, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt Scopus, Jerusalem, Israel (S.C., S.Y.).
authors.forename: Sarah
authors.initials: S
authors.lastname: Cohen
authors.affiliation: School of Women's and Children's Health, University of New South Wales Medicine, and Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia (H.A.); Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel (E.M., O.S.); and Ultrasound Center, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt Scopus, Jerusalem, Israel (S.C., S.Y.). simcha.yagel@gmail.com.
authors.forename: Simcha
authors.initials: S
authors.lastname: Yagel
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004452:Echocardiography / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006176:Gynecology / Q000193:education*; D006801:Humans; D007557:Israel; D008297:Male; D011871:Radiology / Q000193:education*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D062211:Spatio-Temporal Analysis; D013223:Statistics as Topic; D013663:Teaching / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: 3-dimensional sonography; 4-dimensional sonography; echocardiography; fetal heart; prenatal diagnosis; screening examination; spatiotemporal image correlation; training