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Impact of a new image enhancement technology on the biometric measurements in pregnancy
Tania Elger1, Kristina Bettecken1, Natalia Prodan1
1Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.
Objective:
To examine the impact of a new image enhancement technique on biparietal diameter (BPD), head and abdominal circumference (HC and AC), and femur length (FL) measurements as well as the estimated fetal weight (EFW).
Methods:
In this retrospective study, the second and third trimester biometry (BPD, HC, AC, and FL) images that were taken with two GE Voluson E22 ultrasound machines between May and July 2025 were collected. Each measurement was retrospectively obtained using the following settings in sequence: the radiant mode turned off and with the radiant mode turned on minimum, medium, and maximum levels. The measurements were made using automated caliper placement technology. The EFW was calculated using the Hadlock formula. Only the cases where each of the measurements were adequately identified by the automated measurement system were used in the study. Comparisons among the measurements taken without the radiant mode and with the three levels of the radiant mode were then made.
Results:
The study population consisted of 298 women. The median gestational age was 23 weeks. The automated measurement system was able to place the calipers correctly for all required measurements in 253 (84.9%) cases. These cases were then used for further analysis. A comparison of the measurements done without radiant mode and those with the aid of radiant technology showed that BPDs were slightly larger and the FLs were shorter. The HCs and ACs remained unchanged with all three radiant settings. The EFWs also remained unchanged with the minimum radiant setting but were lower with both the medium and maximum radiant setting. The changes were most pronounced with the maximum setting. The average bias was between - 0.11% and 1.51%. The widest range of biases was found for the estimated fetal weight when a maximum radiant mode was used. In this case, 95% of the biases were within - 6.1 and 9.0%.
Conclusion:
The radiant mode can affect the automated fetal biometry, particularly using the maximum mode. Although the average effect is modest, biases may be clinically relevant, especially if other factors increase the extent of the bias.
