ACOUSLIC-AI challenge report: Fetal abdominal circumference measurement on blind-sweep ultrasound data from low-income countries.

Journal: Medical image analysis
Published Date: Jun 10, 2025

Abstract

Fetal growth restriction, affecting up to 10% of pregnancies, is a critical factor contributing to perinatal mortality and morbidity. Ultrasound measurements of the fetal abdominal circumference (AC) are a key aspect of monitoring fetal growth. However, the routine practice of biometric obstetric ultrasounds is limited in low-resource settings due to the high cost of sonography equipment and the scarcity of trained sonographers. To address this issue, we organized the ACOUSLIC-AI (Abdominal Circumference Operator-agnostic UltraSound measurement in Low-Income Countries) challenge to investigate the feasibility of automatically estimating fetal AC from blind-sweep ultrasound scans acquired by novice operators using low-cost devices. Training data, collected from three Public Health Units (PHUs) in Sierra Leone are made publicly available. Private validation and test sets, containing data from two PHUs in Tanzania and a European hospital, are provided through the Grand-Challenge platform. All sets were annotated by experienced readers. Sixteen international teams participated in this challenge, with six teams submitting to the Final Test Phase. In this article, we present the results of the three top-performing AI models from the ACOUSLIC-AI challenge, which are publicly accessible. We evaluate their performance in fetal abdomen frame selection, segmentation, abdominal circumference measurement, and compare their performance against clinical standards for fetal AC measurement. Clinical comparisons demonstrated that the limits of agreement (LoA) for A2 in fetal AC measurements are comparable to the interobserver LoA reported in the literature. The algorithms developed as part of the ACOUSLIC-AI challenge provide a benchmark for future algorithms on the selection and segmentation of fetal abdomen frames to further minimize fetal abdominal circumference measurement variability.

Authors

  • M Sofia Sappia
    Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, Gelderland, The Netherlands; Medical Ultrasound Imaging Center, Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, Gelderland, The Netherlands. Electronic address: mariasofia.sappia@radboudumc.nl.
  • Chris L de Korte
    St. Luke's Catholic Hospital and College of Nursing and Midwifery, Wolisso, Ethiopia; Physics of Fluids Group, MIRA, University of Twente, The Netherlands.
  • Bram van Ginneken
    Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Fraunhofer Mevis, Bremen, Germany.
  • Dean Ninalga
    Independent researcher, Toronto, Canada.
  • Satoshi Kondo
    Konica Minolta, Inc., Osaka, 569-8503, Japan.
  • Satoshi Kasai
    Niigata University of Health and Welfare, Japan.
  • Kousuke Hirasawa
    Konica Minolta, Inc., 1-2, Sakura-machi, Takatsuki, 569-8503, Osaka, Japan.
  • Tanya Akumu
    Department of Mathematics and Computer Science, Universitat de Barcelona, Gran Via de les Corts Catalanes 585, Barcelona, 08007, L'Eixample, Spain.
  • Carlos Martín-Isla
    Dept. de Matemàtiques i Informàtica, Universitat de Barcelona, Spain.
  • Karim Lekadir
    Information and Communication Technologies Department, Universitat Pompeu Fabra, Barcelona, Spain.
  • Víctor M Campello
    Dept. de Matemàtiques i Informàtica, Universitat de Barcelona, Spain.
  • Jorge Fabila
    Department of Mathematics and Computer Science, Universitat de Barcelona, Gran Via de les Corts Catalanes 585, Barcelona, 08007, L'Eixample, Spain.
  • Anette Beverdam
    Department of Obstetrics and Gynaecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, Gelderland, The Netherlands.
  • Jeroen van Dillen
    Department of Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Chase Neff
    Medical Ultrasound Imaging Centre, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Keelin Murphy
    From the Diagnostic Image Analysis Group, Radboud University Medical Center, Geert Groteplein 10, Nijmegen 6500 HB, the Netherlands (K.M., E.T.S., S.S., C.M.S., B.v.G.); Department of Radiology, Bernhoven Hospital, Uden, the Netherlands (H.S.); Department of Radiology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands (A.J.G.K., M.B.J.M.K., T.S., M.R.); Department of Radiology, Meander Medisch Centrum, Amersfoort, the Netherlands (C.M.S.); and Thirona, Nijmegen, the Netherlands (R.H.H.M.P., A.M., J.M.).

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