A computerized diagnostic system for the interpretation of umbilical artery blood flow velocity waveforms

Objective: Development of an artificial intelligent diagnostic system for the interpretation of umbilical artery blood flow velocity waveform measurements. Study design: Study design comprised several stages including data acquisition, image processing and analysis, training of artificial neural network and testing the predictive value of the system. The clinical material was handled in two groups. The training group consisted of 952 umbilical artery blood flow velocity waveform images of 174 normal pregnancies with normal outcome, while the testing group was composed of 138 images derived from 20 normal pregnancies with normal outcome and 68 images of 16 high risk pregnancies with poor outcome. All subjects were evaluated hy Doppler ultrasonography and umbilical artery blood flow velocity waveform images were transferred to the computer environment by means of a special data acquisition system. Automated image processing and analysis were performed to derive indices such as A/B ratio, resistance index, pulse related index, area ratio of wave and angle of coincident slopes. We have used a supervised artificial neural network (back propagation learning algorithm) to develop an intelligent diagnostic system which is called the BOLU system. Results: This version of the system was trained with the umbilical artery blood flow velocity waveform images of normal pregnancies. Thus, the BOLU system decides whether the tested image is normal for a given gestational week or not. The specificity and sensitivity of this system were estimated to be 98.6% and 51.5% respectively. Conclusion: We have developed an artificial intelligent diagnostic system for the interpretation of umbilical artery blood flow velocity waveform measurements. Waveform indices were obtained automatically by image processing and analysis. The predictive value of the system was found to be satisfactory.