Automatic Measurement of Endometrial Thickness From Transvaginal Ultrasound Images

Purpose: Endometrial thickness is one of the most important indicators in endometrial disease screening and diagnosis. Herein, we propose a method for automated measurement of endometrial thickness from transvaginal ultrasound images. Methods: Accurate automated measurement of endometrial thickness relies on endometrium segmentation from transvaginal ultrasound images that usually have ambiguous boundaries and heterogeneous textures. Therefore, a two-step method was developed for automated measurement of endometrial thickness. First, a semantic segmentation method was developed based on deep learning, to segment the endometrium from 2D transvaginal ultrasound images. Second, we estimated endometrial thickness from the segmented results, using a largest inscribed circle searching method. Overall, 8,119 images (size: 852 × 1136 pixels) from 467 cases were used to train and validate the proposed method. Results: We achieved an average Dice coefficient of 0.82 for endometrium segmentation using a validation dataset of 1,059 images from 71 cases. With validation using 3,210 images from 214 cases, 89.3% of endometrial thickness errors were within the clinically accepted range of ±2 mm. Conclusion: Endometrial thickness can be automatically and accurately estimated from transvaginal ultrasound images for clinical screening and diagnosis.