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Women's Health Imaging (Obstetrics and Perinatal Care)

Women's Health Imaging - fetal health, growth and perinatal imaging

Professor Noble's research in this area started over a decade  ago looking at 3D ultrasound image analysis applied in IVF (follicle sizing). Through a collaboration with GE Healthcare we then began to investigate automated 3D/4D analysis of fetal cardiology measurements (see Figure right) .  More recently her group has considerably expanded its women’s health component of the BioMedIA research programme lookiing in more depth at image analysis of fetal growth, image-based clinical indicators to assess pregnancy risk, and perinatal imaging in collaboration with Dr Schnabel  (spanning womb-to-cot).

Fetal cardiologyApplication of imaging and image analysis to monitor the health of the mother-to-be and fetus is a relatively new thing, with clinical management previosuly dominated by vital signals monitoring (a subject of interest elsewhere in the IBME). You can not use X-ray imaging; the use of MR imaging is increasing but hard to as MR is sensitive to motion of the health of the fetus and it is not approved for use in the first trimester. Hence you can only realisitically use ultrasound throughout pregnancy. The 3D/4D technology to do this as significantly advanced in the last 5 years and the opportunity now is to automate analysis. Technically, automating analysis is challenging to do as image quality varies from subject to subject and across gestation, and the object of interest (the fetus) is at an arbitrary view. This pushes the technical boundaries of knowledge of how to process ultrasuond images.

At Oxford, are working with one of the largest maternity hospitals in the UK to do this (the Oxford Women's Centre and the Nuffield Department of Obstetrics and Gynaecology (NDOG)). Recent work has looked, for instance, at quantifying morphological changes of the fetal femur and assessing whether biometry scans are fit for purpose. We are also a member of an international consortium (Intergrowth21st) that is developing fetal growth standards through which we will access to approx. 4000 scans of women at multiple points during pregnancy to develop and validate new methodology. Other recent research has developed analysis techniques for automated structural and functional assessment of the placenta and defining an ultrasound-based soft-tissue biomarker of fetal health. Our group in collaboration with NDOG, also has links with clinical groups in Asia (Shoklo Malaria Research Unit, Thailand)  and Africa (KEMRI, Kenya) with whom we have been investigating how the latest portable ultrasound technology can be utilized to assess malaria in pregnancy and for gestational age estimation respectively. This is an area in which we anticipate growth of the group's activities in the future.

  • Women's health Imaging Team: Alison Noble, Sylvia Rueda, Sana Fathima, Thomas Rackham, Khair Othman, Ana Namburete, Mohammad Ali Marci, Maryam Ahmed.
  • Collaborators: Stephen Kennedy, Aris Papageorghiou, Raphaelle Napolitano, Caroline Knight, Bryn Kemp, Jose Villar, Sally Collins, Lawrence Impey (NDOG); Peter Sullivan, Kenny McCormick, Anil Kopuri (Paediatrics); Gerardine Quaghebeur  (Neuroradiology);
  • Funding: Bill and Melinda Gates Foundation, Centre of Excellence in Medical Engineering funded by the Wellcome Trust/EPSRC, EPSRC.

Representative Publications:

A. Kopuri, S. Rueda, C. Knight, K. McCormick, A. Noble, A. Papageorghiou, P. Sullivan
Neonatal peripheral adiposity measurements using 2D ultrasound in premature infants and comparison with fetal adiposity measures - a novel marker for nutritional status
ESPGHAN 2013, Nutrition, Metabolism, and Experimental Approaches, abstract accepted for oral presentation

S Rueda, C.L. Knight, AT Papageorghiou, JA Noble.
Oriented Feature-Based Coupled Ellipse Fitting for Soft Tissue Quantification in Ultrasound Images.
Proceedings of the IEEE International Symposium on Biomedical Imaging (ISBI) 2013: from Nano to Macro, April 2013, San Francisco, CA, USA.

CL Knight, S Rueda, JA Noble, AT Papageorghiou
Fetal arm fat: an in utero marker of body composition?

Proceedings of the 22nd World Congress on Ultrasound in Obstetrics and Gynecology 2012 (ISUOG), 9-12 September 2012, Copenhagen, Denmark.

R Cuingnet, O Somphone, B Mory, R Prevost, M Yaqub, R Napolitano, A Papageorghiou, D Roundhill, JA Noble, R Ardon.
Where is my Baby? A Fast Fetal Head Auto-Alignment in 3D-Ultrasound.
Proceedings of the the IEEE International Symposium on Biomedical Imaging (ISBI) 2013: from Nano to Macro, April 2013, San Francisco, CA, USA.

M Kuklisova-Murgasova, A Cifor, R Napolitano, A Papageorghiou, G Quaghebeur, JA Noble, JA Schnabel.
Registration of 3D fetal brain US and MRI.

Proceedings of the Medical Imaging and Computer Assisted Interventions (MICCAI), 1-5 October 2012, Nice, France.

B Rahmatullah, A Papageorghiou, JA Noble.
Integration of local and global features for anatomical object detection in ultrasound.

Proceedings of the Medical Imaging and Computer Assisted Interventions (MICCAI), 1-5 October 2012, Nice, France.

G Stevenson, SL Collins, L Impey, JA Noble.
Surface parameterization of the utero/placental interface using 3D power Doppler ultrasound
.
Proc. IEEE International Symposium on Biomedical Imaging (ISBI), pp 891-894, 30 March-2 April, 2011

SL Collins, G Stevenson, J A Noble, L Impey.
Developmental changes in spiral artery blood flow in the human placenta observed with colour Doppler ultrasonography.

Placenta 2012 Oct;33(10):782-7. doi: 10.1016/j.placenta.2012.07.005. Epub 2012 Jul 24.

SL Collins, G Stevenson, JA Noble, L Impey, AW Welsh.
Influence of power Doppler gain setting on Virtual Organ Computer AnaLysis (VOCAL) indices in vivo: can use of the individual sub-noise gain (SNG) level optimise information?

Ultrasound in Obstetrics & Gynecology, July 2012;40(1):75-80. doi: 10.1002/uog.10122.

C Ioannou, M K Javaid, P Mahon, M Yaqub, NC Harvey, KM Godfrey, JA Noble, C Cooper, AT Papageorghiou.
The effect of maternal vitamin D concentration on fetal bone.

Journal of Clinical Endocrinology & Metabolism Nov 2012;97(11):E2070-7. doi: 10.1210/jc.2012-2538. Epub 2012 Sep 18.

M Yaqub, K Javaid, C Cooper, JA Noble.
Improving the classification accuracy of the classic RF method by intelligent feature selection and weighted voting of trees with application to medical image segmentation.
Proc. International Workshop on Machine Learning in Medical Imaging (MLMI ), Toronto, 18 Sept 2011.

MJ Rijken, WE Moroski, S Kiricharoen, N Karunkonkowit, G Stevenson, E Ohuma, JA Noble, SH Kennedy, R McGready, A Papageorghiou and FH Nosten
Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study.

Malaria Journal, 2012 vol.11(5) doi:10.1186/1475-2875-11-5