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Explainable Quality Assessment and Measurement from Real-World Hip Ultrasound Cine Sweeps.

Adam McArthur1, Stephanie Wichuk1, Stephen Burnside1

  • 1Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2R3, Canada.

Bioengineering (Basel, Switzerland)
|June 26, 2026
PubMed
Summary

Retuve, an automated infant hip ultrasound analysis tool, effectively identifies analyzable frames but requires refinement for precise alpha-angle measurements in diagnosing developmental dysplasia of the hip (DDH).

Keywords:
biomedical applicationscine sweep ultrasounddeep learningdevelopmental dysplasia of the hipexplainable AIhip ultrasoundmedical imaging

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Area of Science:

  • Medical Imaging
  • Artificial Intelligence in Medicine
  • Pediatric Orthopedics

Background:

  • Infant hip ultrasound (IHUS) is crucial for diagnosing developmental dysplasia of the hip (DDH).
  • Automated analysis of IHUS cine sweeps can improve efficiency and consistency.
  • Existing tools often lack explainability and struggle with variable image quality.

Purpose of the Study:

  • To evaluate Retuve, an open-source explainable pipeline for automated analysis of infant hip ultrasound cine sweeps.
  • To assess Retuve's performance in frame selection, Graf-plane calibration, and measurement extraction.
  • To identify areas for improvement in automated IHUS analysis.

Main Methods:

  • Retuve pipeline combines automated segmentation, Graf-plane calibration, and frame filtering.
  • Retrospective multicenter study with external validation on 109 hips.
  • Internal developmental validation of segmentation and calibration components.

Main Results:

  • Retuve achieved 100% specificity and 91% sensitivity in identifying analyzable frames, outperforming a radiology fellow.
  • Intraclass correlation coefficients (ICCs) for alpha angle and acetabular coverage were comparable to a fellow.
  • Lower absolute agreement for alpha angle suggests systematic measurement bias requiring refinement.

Conclusions:

  • Retuve demonstrates potential for automated IHUS analysis, particularly in selecting analyzable frames.
  • The pipeline shows promise but requires further development for accurate alpha-angle measurement.
  • Future research should focus on prospective evaluation for DDH diagnostic accuracy and clinical utility.