PMID- 28508418
OWN - NLM
STAT- MEDLINE
DCOM- 20181019
LR  - 20181019
IS  - 1469-0705 (Electronic)
IS  - 0960-7692 (Linking)
VI  - 51
IP  - 5
DP  - 2018 May
TI  - Quantitative analysis of cervical texture by ultrasound in mid-pregnancy and
      association with spontaneous preterm birth.
PG  - 637-643
LID - 10.1002/uog.17525 [doi]
AB  - OBJECTIVE: New tools are required to improve the identification of women who are 
      at increased risk for spontaneous preterm birth (sPTB). Quantitative analysis of 
      tissue texture on ultrasound has been used to extract robust features from the
      ultrasound image to detect subtle changes in its microstructure. This may be
      applied to the cervix. The aim of this study was to determine if there is an
      association between quantitative analysis of cervical texture (CTx) on
      mid-trimester ultrasound and sPTB < 37 + 0 weeks' gestation. METHODS: This was a 
      single-center nested case-control study of a prospective cohort of 677
      consecutive women with singleton pregnancy assessed between 19 + 0 and 24 + 6
      weeks' gestation. Women at increased risk for sPTB were included unless they
      received treatment to prevent sPTB. Women who delivered < 37 + 0 weeks (sPTB)
      were considered as cases and were matched in a 1: 10 ratio with randomly selected
      contemporary controls who delivered at term. For each woman, one ultrasound image
      of the cervix was obtained for which quality was assessed, cervical length (CL)
      measured offline and a region of interest in the midportion of the anterior
      cervical lip delineated for use in local binary patterns analysis of CTx. A
      learning algorithm was developed to obtain the combination of CTx features best
      associated with sPTB based on feature transformation and discriminant analysis
      regression. The ability of the learning algorithm to predict sPTB was evaluated
      using a leave-one-out cross-validation technique, which produced a CTx-based
      score for each participant. Receiver-operating characteristics (ROC) curves were 
      produced and sensitivity, specificity, and positive and negative likelihood
      ratios were calculated for the optimal cut-off based on the ROC curve. The
      results were compared with those obtained for CL. Investigators studying the
      images were blinded to pregnancy outcome at all times. RESULTS: Images from 310
      women (27 cases and 283 controls) were of sufficient quality and included in the 
      study. Median CTx-based score was significantly lower in cases compared with
      controls (-1.01 vs -0.07, P </= 0.0001). CTx-based score maintained its
      significant association with sPTB after adjusting for possible confounders
      (history of sPTB, conization or Mullerian malformation, and CL < 25 mm).
      CTx-based score was a better predictor of sPTB (AUC, 0.77; 95% CI, 0.66-0.87)
      than was CL (AUC, 0.60; 95% CI, 0.47-0.72) (P = 0.03). Median CL was similar for 
      cases and controls (37.7 vs 38.6 mm, P = 0.26), although cases were more likely
      to have CL < 25 mm (18.5% vs 0.4%, P < 0.001). CONCLUSION: Quantitative analysis 
      of CTx enables the extraction of information relevant to sPTB from ultrasound
      images to generate a CTx-based score that is associated independently with sPTB. 
      Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.
CI  - Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.
FAU - Banos, N
AU  - Banos N
AD  - Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for
      Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de
      Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Institut
      d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, and
      Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
FAU - Perez-Moreno, A
AU  - Perez-Moreno A
AD  - Transmural Biotech S. L., Barcelona, Spain.
FAU - Julia, C
AU  - Julia C
AD  - Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for
      Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de
      Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Institut
      d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, and
      Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
FAU - Murillo-Bravo, C
AU  - Murillo-Bravo C
AD  - Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for
      Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de
      Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Institut
      d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, and
      Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
FAU - Coronado, D
AU  - Coronado D
AD  - Transmural Biotech S. L., Barcelona, Spain.
FAU - Gratacos, E
AU  - Gratacos E
AD  - Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for
      Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de
      Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Institut
      d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, and
      Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
FAU - Deprest, J
AU  - Deprest J
AD  - Clinical Department Obstetrics and Gynecology, University Hospitals KU Leuven and
      Academic Department Development and Regeneration, Biomedical Sciences, KU Leuven,
      Leuven, Belgium.
FAU - Palacio, M
AU  - Palacio M
AD  - Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for
      Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de
      Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Institut
      d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, and
      Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Validation Studies
DEP - 20180402
PL  - England
TA  - Ultrasound Obstet Gynecol
JT  - Ultrasound in obstetrics & gynecology : the official journal of the International
      Society of Ultrasound in Obstetrics and Gynecology
JID - 9108340
SB  - IM
MH  - Adult
MH  - Case-Control Studies
MH  - Cervical Length Measurement/*methods
MH  - Cervix Uteri/anatomy & histology/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - Pregnancy Trimester, Second
MH  - Premature Birth/*diagnosis/prevention & control
MH  - Prospective Studies
MH  - ROC Curve
MH  - Risk Factors
OTO - NOTNLM
OT  - image biomarker
OT  - quantitative ultrasound
OT  - spontaneous preterm birth
OT  - texture analysis
OT  - uterine cervix
EDAT- 2017/05/17 06:00
MHDA- 2017/05/17 06:00
CRDT- 2017/05/17 06:00
PHST- 2017/02/10 00:00 [received]
PHST- 2017/04/14 00:00 [revised]
PHST- 2017/05/05 00:00 [accepted]
PHST- 2017/05/17 06:00 [pubmed]
PHST- 2017/05/17 06:00 [medline]
PHST- 2017/05/17 06:00 [entrez]
AID - 10.1002/uog.17525 [doi]
PST - ppublish
SO  - Ultrasound Obstet Gynecol. 2018 May;51(5):637-643. doi: 10.1002/uog.17525. Epub
      2018 Apr 2.