Automated Measurement of Fetal Right-Myocardial Performance Index from Pulsed Wave Doppler Spectrum

Congenital heart disease is the leading cause of birth defect related deaths. The modified myocardial performance index of the right ventricle (R-MPI) is a sensitive and early clinical indicator of fetal cardiac health. Objective repeatable measurement of R-MPI is an important deciding factor for the clinical adaptation of the R-MPI. In this work, we describe a novel method for automatic computation of R-MPI from the Pulsed Wave Doppler (PWD) images. Our method involves a Fourier series based cardiac cycle detection followed by an adaptive windowed energy based valve click localization and weighted gradient based refinement. Using this method, we have been able to measure R-MPI reliably with a mean difference of 0.0075 +/- 0.034 from 170 expert annotations on 68 fetal PWD images with an Intra-Class Correlation (ICC) of 0.9380. Furthermore, we have introduced novel methods for normalization and synchronization of PWD images acquired at two different time intervals for the assessment of iso-volume time intervals and an accurate measurement of R-MPI.