SYSTEM AND METHOD FOR AUTOMATICALLY TRACKING A MINIMAL HIATAL DIMENSION PLANE OF AN ULTRASOUND VOLUME IN REAL-TIME DURING A PELVIC FLOOR EXAMINATION

Systems and methods for automatically tracking a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination are provided. The method includes acquiring an ultrasound volume of an anatomical region over a time period. The method includes extracting an A-plane from the ultrasound volume and displaying the A-plane. The method includes receiving an OmniView (OV) line overlaid on the A-plane. The method includes rendering an OV-plane based on a position and trajectory of the OV-line and displaying the OV-plane. The method includes automatically identifying key points in regions of interest in the A-plane. The method includes automatically tracking the key points in the regions of interest in the A-plane over the time period to automatically adjust the position and trajectory of the OV-line, the rendering the OV-plane automatically updating over the time period based on adjustments of the position and trajectory of the OV-line.

FIELD

Certain embodiments relate to ultrasound imaging. More specifically, certain embodiments relate to a method and system for automatically tracking a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination.

BACKGROUND

Ultrasound imaging is a medical imaging technique for imaging organs and soft tissues in a human body. Ultrasound imaging uses real time, non-invasive high frequency sound waves to produce a series of two-dimensional (2D), three-dimensional (3D) images, and/or four-dimensional (4D) images.

Ultrasound volume acquisitions are typically described as three planes, including the A-plane, the B-plane, and the C-plane. The A-plane is the plane parallel to the acquisition plane. The B-plane is also parallel to the acquisition plane but is perpendicular to the A-plane. The C-plane, which is also known as the coronal plane, includes a thickness of two-dimensional slices parallel to and at various depths from the transducer face (i.e., perpendicular to the ultrasound beam).

Pelvic floor ultrasound examinations may be utilized to assess structural integrity of the levator ani muscle, assess possible pelvic organ prolapse, and/or assess proper functioning and strength of the pelvic floor muscles. Pelvic floor examinations are critical to evaluating the integrity of pelvic muscles and determining any preventive and/or corrective actions, including surgical intervention. During a pelvic floor examination, an ultrasound operator may perform a 4D ultrasound acquisition (i.e., 3D image acquisition over time) while the patient performs different muscle maneuvers. The ultrasound system may present the A-plane and an ultrasound operator may position an OmniView line (OV-line) or render box overlaid on the A-plane. The OV-line or render box defines the location in the 3D ultrasound volume to render as the OV-plane (i.e., corresponding to the minimal hiatal dimension view of the levator hiatus). The OV-plane may approximately correspond with the C-plane. For example, the ultrasound system may render the OV-plane from a thickness of 1-2 centimeters below the OV-line, or may render the OV-plane from image data bounded by the render box. During the pelvic floor ultrasound examination, the ultrasound system may display the A-plane and the OV-plane corresponding to the OV-line or render box in split screen.

The ultrasound operator continually monitors the dynamic images to ascertain the correctness of the maneuver and the integrity of the muscle structure and function during the pelvic floor examination. However, even though the probe is held stationary, the OV-plane corresponding with the static location of the OV-line or render box does not continue to present the correct viewing plane due to the relaxation (Valsalva phase) and contraction (contraction phase) of the muscles. Consequently, after acquisition, the operator or other medical professional performs an offline analysis to select a frame of the volume acquisition (e.g., corresponding with maximal Valsalva or maximal contraction), and reposition the OV-line or render box to obtain the rendering of the OV-plane having the minimal hiatal dimension in view such that measurements and diagnosis may be performed.

The present pelvic floor ultrasound examination workflow includes several problems and inefficiencies. For example, an ultrasound operator typically is only able to view the correct OV-plane in the selected 3D volume frame (i.e., after the 3D volume frame is selected and the OV-line or render box is repositioned). As another example, the process of selecting the 3D volume frame is subjective, which requires operator expertise and may result in fatigue, errors, inconsistencies, and/or non-robust clinical performance. In addition, the correct OV-plane image view is only available retrospectively (i.e., not in real-time during the examination), and only after adjusting of the OV-line or render box. This is because the OV-plane rendered volumes presented during the pelvic floor examination all correspond to the initially positioned OV-line or render box, despite the movement of the muscles during the examination.

BRIEF SUMMARY

A system and/or method is provided for automatically tracking a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination, substantially as shown in and/or described in connection with at least one of the figures, as set forth more completely in the claims.

DETAILED DESCRIPTION

Certain embodiments may be found in a method and system for automatically tracking a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination. Aspects of the present disclosure have the technical effect of automatically tracking and dynamically adjusting a position and trajectory of an OmniView (OV) line in real-time during a live ultrasound volume acquisition such that a corresponding OV-image is rendered, presented, and updated throughout the live acquisition. Various embodiments have the technical effect of automatically computing strain and providing strain information with the OV-image.

The foregoing summary, as well as the following detailed description of certain embodiments will be better understood when read in conjunction with the appended drawings. To the extent that the figures illustrate diagrams of the functional blocks of various embodiments, the functional blocks are not necessarily indicative of the division between hardware circuitry. Thus, for example, one or more of the functional blocks (e.g., processors or memories) may be implemented in a single piece of hardware (e.g., a general-purpose signal processor or a block of random access memory, hard disk, or the like) or multiple pieces of hardware. Similarly, the programs may be stand alone programs, may be incorporated as subroutines in an operating system, may be functions in an installed software package, and the like. It should be understood that the various embodiments are not limited to the arrangements and instrumentality shown in the drawings. It should also be understood that the embodiments may be combined, or that other embodiments may be utilized, and that structural, logical and electrical changes may be made without departing from the scope of the various embodiments. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present disclosure is defined by the appended claims and their equivalents.

Also as used herein, the term “image” broadly refers to both viewable images and data representing a viewable image. However, many embodiments generate (or are configured to generate) at least one viewable image. In addition, as used herein, the phrase “image” is used to refer to an ultrasound mode such as B-mode (2D mode), M-mode, three-dimensional (3D) mode, CF-mode, PW Doppler, CW Doppler, Contrast Enhanced Ultrasound (CEUS), and/or sub-modes of B-mode and/or CF such as Harmonic Imaging, Shear Wave Elasticity Imaging (SWEI), Strain Elastography, TVI, PDI, B-flow, MVI, UGAP, and in some cases also MM, CM, TVD where the “image” and/or “plane” includes a single beam or multiple beams.

Furthermore, the term processor or processing unit, as used herein, refers to any type of processing unit that can carry out the required calculations needed for the various embodiments, such as single or multi-core: CPU, Accelerated Processing Unit (APU), Graphic Processing Unit (GPU), DSP, FPGA, ASIC or a combination thereof.

Although certain embodiments may describe the ultrasound examination in the context of a pelvic floor examination, for example, unless so claimed, the scope of various aspects of the present disclosure should not be limited to pelvic floor ultrasound examinations and may additionally and/or alternatively be applicable to any suitable ultrasound examination of anatomical regions having moving anatomical structures (e.g., heart, fetus, and the like).

It should be noted that various embodiments described herein that generate or form images may include processing for forming images that in some embodiments includes beamforming and in other embodiments does not include beamforming. For example, an image can be formed without beamforming, such as by multiplying the matrix of demodulated data by a matrix of coefficients so that the product is the image, and wherein the process does not form any “beams”. Also, forming of images may be performed using channel combinations that may originate from more than one transmit event (e.g., synthetic aperture techniques).

In various embodiments, ultrasound processing to form images is performed, for example, including ultrasound beamforming, such as receive beamforming, in software, firmware, hardware, or a combination thereof. One implementation of an ultrasound system having a software beamformer architecture formed in accordance with various embodiments is illustrated inFIG.1.

FIG.1is a block diagram of an exemplary ultrasound system100that is operable to automatically track a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination, in accordance with various embodiments. Referring toFIG.1, there is shown an ultrasound system100and a training system200. The ultrasound system100comprises a transmitter102, an ultrasound probe104, a transmit beamformer110, a receiver118, a receive beamformer120, A/D converters122, a RF processor124, a RF/IQ buffer126, a user input device130, a signal processor132, an image buffer136, a display system134, and an archive138.

The transmitter102may comprise suitable logic, circuitry, interfaces and/or code that may be operable to drive an ultrasound probe104. The ultrasound probe104may comprise a two dimensional (2D) array of piezoelectric elements. Additionally and/or alternatively, the ultrasound probe104may be a mechanically wobbling ultrasound probe104, which may comprise a one dimensional (1D) array of piezoelectric elements mounted on a transducer assembly movable in a single plane. For example, the transducer assembly may be movable approximately 120 to 150 degrees by a motor driving gears, belts, and/or rope to pivot an axis or hub of the transducer assembly. The ultrasound probe104may comprise a group of transmit transducer elements106and a group of receive transducer elements108, that normally constitute the same elements. The group of transmit transducer elements106may emit ultrasonic signals through oil and a probe cap and into a target. In a representative embodiment, the ultrasound probe104may be operable to acquire ultrasound image data covering at least a substantial portion of an anatomy, such as a pelvic region or any suitable anatomical region. In an exemplary embodiment, the ultrasound probe104may be operated in a volume acquisition mode, where the transducer assembly of the ultrasound probe104is moved to acquire a plurality of parallel 2D ultrasound slices forming an ultrasound volume.

The transmit beamformer110may comprise suitable logic, circuitry, interfaces and/or code that may be operable to control the transmitter102which, through a transmit sub-aperture beamformer114, drives the group of transmit transducer elements106to emit ultrasonic transmit signals into a region of interest (e.g., human, animal, underground cavity, physical structure and the like). The transmitted ultrasonic signals may be back-scattered from structures in the object of interest, like blood cells or tissue, to produce echoes. The echoes are received by the receive transducer elements108.

The group of receive transducer elements108in the ultrasound probe104may be operable to convert the received echoes into analog signals, undergo sub-aperture beamforming by a receive sub-aperture beamformer116and are then communicated to a receiver118. The receiver118may comprise suitable logic, circuitry, interfaces and/or code that may be operable to receive the signals from the receive sub-aperture beamformer116. The analog signals may be communicated to one or more of the plurality of A/D converters122.

The plurality of A/D converters122may comprise suitable logic, circuitry, interfaces and/or code that may be operable to convert the analog signals from the receiver118to corresponding digital signals. The plurality of A/D converters122are disposed between the receiver118and the RF processor124. Notwithstanding, the disclosure is not limited in this regard. Accordingly, in some embodiments, the plurality of A/D converters122may be integrated within the receiver118.

The RF processor124may comprise suitable logic, circuitry, interfaces and/or code that may be operable to demodulate the digital signals output by the plurality of A/D converters122. In accordance with an embodiment, the RF processor124may comprise a complex demodulator (not shown) that is operable to demodulate the digital signals to form I/Q data pairs that are representative of the corresponding echo signals. The RF or I/Q signal data may then be communicated to an RF/IQ buffer126. The RF/IQ buffer126may comprise suitable logic, circuitry, interfaces and/or code that may be operable to provide temporary storage of the RF or I/Q signal data, which is generated by the RF processor124.

The receive beamformer120may comprise suitable logic, circuitry, interfaces and/or code that may be operable to perform digital beamforming processing to, for example, sum the delayed channel signals received from RF processor124via the RF/IQ buffer126and output a beam summed signal. The resulting processed information may be the beam summed signal that is output from the receive beamformer120and communicated to the signal processor132. In accordance with some embodiments, the receiver118, the plurality of A/D converters122, the RF processor124, and the beamformer120may be integrated into a single beamformer, which may be digital. In various embodiments, the ultrasound system100comprises a plurality of receive beamformers120.

The user input device130may be utilized to input patient data, scan parameters, settings, select protocols and/or templates, select a position and trajectory of an OmniView (OV) line, select measurements, and the like. In an exemplary embodiment, the user input device130may be operable to configure, manage and/or control operation of one or more components and/or modules in the ultrasound system100. In this regard, the user input device130may be operable to configure, manage and/or control operation of the transmitter102, the ultrasound probe104, the transmit beamformer110, the receiver118, the receive beamformer120, the RF processor124, the RF/IQ buffer126, the user input device130, the signal processor132, the image buffer136, the display system134, and/or the archive138. The user input device130may include button(s), rotary encoder(s), a touchscreen, motion tracking, voice recognition, a mousing device, keyboard, camera and/or any other device capable of receiving a user directive. In certain embodiments, one or more of the user input devices130may be integrated into other components, such as the display system134or the ultrasound probe104, for example. As an example, user input device130may include a touchscreen display.

The signal processor132may comprise suitable logic, circuitry, interfaces and/or code that may be operable to process ultrasound scan data (i.e., summed IQ signal) for generating ultrasound images for presentation on a display system134. The signal processor132is operable to perform one or more processing operations according to a plurality of selectable ultrasound modalities on the acquired ultrasound scan data. In an exemplary embodiment, the signal processor132may be operable to perform display processing and/or control processing, among other things. Acquired ultrasound scan data may be processed in real-time during a scanning session as the echo signals are received. Additionally or alternatively, the ultrasound scan data may be stored temporarily in the RF/IQ buffer126during a scanning session and processed in less than real-time in a live or off-line operation. In various embodiments, the processed image data can be presented at the display system134and/or may be stored at the archive138. The archive138may be a local archive, a Picture Archiving and Communication System (PACS), or any suitable device for storing images and related information.

The signal processor132may be one or more central processing units, microprocessors, microcontrollers, and/or the like. The signal processor132may be an integrated component, or may be distributed across various locations, for example. In an exemplary embodiment, the signal processor132may comprise an A-plane extraction processor140, an OV-line processor150, an OV-plane rendering processor160, and a measurement processor170. The signal processor132may be capable of receiving input information from a user input device130and/or archive138, generating an output displayable by a display system134, and manipulating the output in response to input information from a user input device130, among other things. The signal processor132, A-plane extraction processor140, OV-line processor150, OV-plane rendering processor160, and measurement processor170may be capable of executing any of the method(s) and/or set(s) of instructions discussed herein in accordance with the various embodiments, for example.

The ultrasound system100may be operable to continuously acquire ultrasound scan data at a frame rate that is suitable for the imaging situation in question. Typical frame rates range from 20-120 but may be lower or higher. The acquired ultrasound scan data may be displayed on the display system134at a display-rate that can be the same as the frame rate, or slower or faster. An image buffer136is included for storing processed frames of acquired ultrasound scan data that are not scheduled to be displayed immediately. Preferably, the image buffer136is of sufficient capacity to store at least several minutes' worth of frames of ultrasound scan data. The frames of ultrasound scan data are stored in a manner to facilitate retrieval thereof according to its order or time of acquisition. The image buffer136may be embodied as any known data storage medium.

The signal processor132may include an A-plane extraction processor140that comprises suitable logic, circuitry, interfaces and/or code that may be operable to extract and sequentially present, one at a time, the A-plane two-dimensional (2D) ultrasound image slice (i.e., the plane parallel to the acquisition plane) from a four-dimensional (4D) ultrasound volume (i.e., three-dimensional (3D) ultrasound volume over time) of a pelvic region or any suitable anatomical region. For example, the A-plane extraction processor140may be configured to automatically extract the A-plane from ultrasound volumes acquired over time and present the extracted A-plane at the display system134. For example, the A-plane extraction processor140may be configured to generate a cine loop of extracted A-planes for playback at the display system134. The ultrasound operator may provide pause, play, rewind, and/or fast forward instructions via the user input device to the A-plane extraction processor140to control playback of the cine loop. The ultrasound operator may control playback of the cine loop to view pelvic muscles at maximal Valsalva and maximal contraction for measurement. The A-plane extraction processor140may be configured to store the extracted A-plane images and/or cine loop at archive138and/or any suitable data storage medium.

The signal processor132may include an OV-line processor150that comprises suitable logic, circuitry, interfaces and/or code that may be operable to receive an initial position and trajectory of an OV-line in an initial A-plane image. The OV-line processor150may be configured to receive a user positioning of the OV-line overlaid on the initial A-plane image via the user input device130. For example, in a pelvic floor examination, the OV-line may be positioned to extend through the symphysis pubis (SP) and levator ani (LA). The OV-line defines the image data of the ultrasound volume to be rendered to generate the OV-plane, which may generally correspond with the C-plane (i.e., a thickness of two-dimensional slices parallel to and at various depths from the transducer face). In a pelvic floor examination, the OV-line defines the OV-plane, which corresponds with the minimal hiatal dimension plane. In various embodiments, the rendered image data may have a thickness of 1-2 centimeters (cm) below the OV-line. The OV-line processor150is configured to provide the initial position and trajectory of the OV-line to the OV-plane rendering processor160, such that the OV-plane rendering processor160may render and display the OV-plane image with the corresponding A-plane image based on the OV-line. Additionally or alternatively, the OV-line processor150may be configured to store the position and trajectory of the OV-line and/or the A-plane image having the OV-line at archive138and/or any suitable data storage medium.

The OV-line processor150may comprise suitable logic, circuitry, interfaces and/or code that may be operable to track the OV-line to automatically adjust the position and trajectory of the OV-line in subsequent A-plane images over the acquisition time period. In this regard, the OV-line processor150may include, for example, artificial intelligence image analysis algorithms, computer vision algorithms, one or more deep neural networks (e.g., a convolutional neural network such as u-net) and/or may utilize any suitable form of image analysis techniques or machine learning processing functionality configured to track a position and trajectory of the OV-line in A-plane images over an acquisition time period. Additionally and/or alternatively, the artificial intelligence image analysis techniques or machine learning processing functionality configured to track the position and trajectory of the OV-line in the A-plane images may be provided by a different processor or distributed across multiple processors at the ultrasound system100and/or a remote processor communicatively coupled to the ultrasound system100.

As an example, the OV-line tracking functionality may be provided as a deep neural network that may be made up of, for example, an input layer, an output layer, and one or more hidden layers in between the input and output layers. Each of the layers may be made up of a plurality of processing nodes that may be referred to as neurons. For example, the OV-line tracking functionality may include an input layer having a neuron for each pixel of an A-plane image. The output layer may have a neuron corresponding to an updated position and trajectory of the OV-line. Each neuron of each layer may perform a processing function and pass the processed ultrasound image information to one of a plurality of neurons of a downstream layer for further processing. As an example, neurons of a first layer may learn to recognize edges of structure in the extracted A-plane image. The neurons of a second layer may learn to recognize shapes based on the detected edges from the first layer. The neurons of a third layer may learn positions of the recognized shapes relative to landmarks in the extracted A-plane image. The neurons of a fourth layer may learn to recognize regions of interest in the A-plane image, such as the symphysis pubis (SP) and levator ani (LA) in an A-plane image of a pelvic floor examination. The neurons of a fifth layer may learn to recognize key points in the identified regions of interest. The key points may be landmarks or other trackable features in the A-plane image. The processing performed by the deep neural network may track an updated position and trajectory of the OV-line based on the tracked key points in the identified regions of interest in the A-plane image with a high degree of probability.

In an exemplary embodiment, the OV-line processor150may be configured to store the OV-line position and trajectory information and/or the A-plane image having the adjusted OV-line at archive138and/or any suitable storage medium. The OV-line processor150may be configured to provide the OV-plane rendering processor160with the OV-line position and trajectory information, such that the OV-plane rendering processor160may render the OV-plane image based on the OV-line position and trajectory information and present the rendered OV-plane at the display system134, as described below.

The signal processor132may include an OV-plane rendering processor160that comprises suitable logic, circuitry, interfaces and/or code that may be operable to render an OV-plane based on the OV-line received from the OV-line processor150and present the rendered OV-plane at the display system134. For example, the OV-plane rendering processor160may be configured to receive the OV-line position and trajectory information from the OV-line processor150. The OV-plane rendering processor160may be configured to render a 2D projection of the 3D ultrasound volume based on the OV-line position and trajectory information. For example, the OV-plane rendering processor160may render the 2D projection (i.e., the OV-plane image) from a thickness of 1-2 cm of the ultrasound volume below the OV-line. The rendered OV-plane image may generally correspond to the C-plane. In a pelvic floor examination, the rendered OV-plane image corresponds with the minimum hiatal distance (MHD) plane of the levator hiatus. The OV-plane rendering processor160continues to render and present the OV-plane image based on any adjustments to the position and trajectory of the OV-line during the acquisition time period. The OV-plane rendering processor160may be configured to present the rendered OV-plane image with the corresponding A-plane image having the OV-line. For example, the A-plane image having the OV-line and the OV-plane image may be presented in a split-screen view at the display system134. The OV-plane rendering processor160may be configured to store the rendered OV-planes at archive138and/or any suitable data storage medium.

FIG.2is an illustration of an exemplary three-dimensional (3D) ultrasound volume acquisition300having an A-plane310, B-plane330, and OV-plane320, and exemplary displayed two-dimensional (2D) images including the A-plane310having an OV-line312and an OV-plane rendering320, in accordance with various embodiments. Referring toFIG.2, the 3D ultrasound volume300may comprise an A-plane310, B-plane330, and an OV-plane320. The OV-plane320may generally correspond with a C-plane (i.e., a thickness of 2D slices parallel to and at various depths from the transducer face). The OV-plane320is rendered and presented based on a position and trajectory of an OV-line312. The OV-line312may initially be positioned in the A-plane image310via the user input device130. The position and trajectory of the OV-line312may be automatically tracked and adjusted in subsequent A-plane images310extracted from ultrasound volumes300acquired over time (i.e., a 4D acquisition). The OV-plane image320is automatically updated with adjustments to the OV-line312over the acquisition time period.

FIG.3is exemplary displays400A,400B of two-dimensional (2D) A-plane images410A,410B and OV-plane renderings420A,420B at a first time400A and a second subsequent time400B during a pelvic floor examination, in accordance with various embodiments. Referring toFIG.3, an A-plane image410A extracted from an ultrasound volume acquired at a first time400A may be presented at a display system134. An ultrasound operator may superimpose an OV-line412A on the A-plane image410A and an OV-plane rendering processor160may render and present an OV-plane image420A corresponding with the OV-line412A position and trajectory in the A-plane410A. In various embodiments, 10-30 ultrasound volumes may be acquired over time (i.e., 4D acquisition) during the pelvic floor examination. The A-plane image410is extracted from each ultrasound volume and the position and trajectory of the OV-line412is automatically tracked and adjusted based on movement in the anatomical region (e.g., as a patient performs contraction and Valsalva muscle maneuvers during the pelvic floor examination). The OV-plane image420B is rendered and presented based on the adjusted OV-line412B in an A-plane image410B extracted from an ultrasound volume acquired at the second subsequent time. Due to the dynamic tracking and adjustment of the OV-line412A,412B throughout the pelvic floor examination, the correct OV-plane image420A,420B illustrating the minimum hiatal distance (MHD) plane of the levator hiatus is rendered and presented throughout the pelvic floor examination.

FIG.4is an exemplary display500of a two-dimensional (2D) A-plane image510having regions of interest514and key points516, in accordance with various embodiments. Referring toFIG.4, the OV-line processor150may be configured to automatically identify regions of interest514in the extracted A-plane images510. For example, in a pelvic floor examination, the OV-line is positioned to extend through the symphysis pubis (SP) and levator ani (LA) regions of the pelvic region. The OV-line processor150may be configured to automatically identify the symphysis pubis (SP) and levator ani (LA) as the regions of interest514in the A-plane image510. The OV-line processor150may be configured to automatically select key points516in the identified regions of interest514. The key points516may correspond with landmarks and/or other trackable features in the A-plane image510. The OV-line processor150may be configured to automatically track the regions of interest514and key points516in subsequently acquired A-plane images510to adjust the position and trajectory of an OV-line.

Referring again toFIG.1, the signal processor132may include a measurement processor170that comprises suitable logic, circuitry, interfaces and/or code that may be operable to perform measurements of one or more of the OV-plane images320,420A,420B rendered and presented during the examination time period. For example, the measurement processor170may be configured to compute strain of pelvic floor muscles in the OV-plane image320,420A,420B of the levator hiatus. As an example, the Valsalva and contraction maneuvers of a pelvic floor examination cause tissue distortion. The ultrasound signals in the OV-plane320,420A,420B may be tracked to compute the strain based on speckle tracking or direct strain computation (e.g., where displacements of small signal segments between two frames are first estimated, and then strains are obtained by taking the derivatives of the displacements), for example. The measurement processor170may be configured to generate a strain image, a graph of the strain values, and/or may overlay the strain information (e.g., color-coded) on the OV-plane image320,420A,420B. In various embodiments, the measurement processor170may be configured to deploy a pelvic floor disorder risk artificial intelligence model to predict a risk of developing a pelvic floor disorder. For example, the model may be trained based on strain images, B-mode images, patient demographic information (e.g., age, body mass index (BMI), medical history (e.g., number of vaginal deliveries, diabetes, etc.), and the like). The measurement processor170may be configured to inference the model to generate a predicted risk, which may be displayed as an icon (e.g., risk meter), level (e.g., low, medium, high), and/or number (e.g., 1-5). The predicted risk may be color-coded (e.g., high risk represented by red, medium risk represented by yellow, and low risk represented by green). The predicted risk may be displayed with one or more of the A-plane image310,410A,410B having the OV-line312,412A,412B, the OV-plane image320,420A,420B, a strain image, a strain graph, the OV-plane image320,420A,420B with overlaid strain information, and/or the like.

As another example, the measurement processor170may be configured to compute area, length, and height based on the contours of the levator hiatus (e.g., contours of the levator hiatus at maximal contraction and maximal Valsalva). The area, length, and height measurements for each of the maximal contraction and maximal Valsalva phases, as well as ratios of the area, length, and height measurements between the maximal contraction and maximal Valsalva phases, may be presented at the display system134.

In various embodiments, the measurement processor170may be configured to present measurements from past and current examinations to evaluate the treatment and disease progression over time. The measurement processor170may be configured to store the measurements (e.g., strain information, strain images, strain graphs, OV-plane images with superimposed strain information, area measurements, length measurements, height measurements, ratio measurements, and the like) at archive138and/or any suitable data storage medium.

FIG.5is an exemplary display of a strain image600, in accordance with various embodiments. Referring toFIG.5, a strain image600of the levator hiatus is shown. The strain image600may be color-coded to illustrate strain values corresponding to different locations of the levator hiatus. The strain image600may be generated by the measurement processor170based on analysis of ultrasound signals (e.g., speckle tracking or direct strain computation) of the OV-plane images320,420A,420B during the examination. The strain image600may be presented at the display system134by itself or with one or more of the A-plane image310,410A,410B having the OV-line312,412A,412B, the OV-plane image320,420A,420B, a strain graph, the OV-plane image320,420A,420B with overlaid strain information, area measurements, length measurements, height measurements, ratio measurements, and/or the like. The strain image600may be stored at archive138and/or any suitable data storage medium.

FIG.6is an exemplary display700of a two-dimensional (2D) A-plane image710having an OV-line712and an OV-plane rendering720overlaid with strain information722, in accordance with various embodiments. Referring toFIG.6, the A-plane image710comprises an OV-line712extending between the symphysis pubis (SP) and levator ani (LA) regions of the pelvic region. The OV-plane image720is a rendering of a thickness of 1-2 cm of image data in the acquired ultrasound volume below the OV-line712. The measurement processor170computes strain information722by analyzing the OV-plane images720acquired over the examination time period based on speckle tracking or direct strain computation, for example. The computed strain information722is superimposed on the OV-plane image720. In various embodiments, the strain information722may be color-coded based on the strain values at the different locations in the OV-plane image720. The A-plane image710having the OV-line712and the OV-plane image720having the strain information722may be presented at the display system134. In certain embodiments, additional measurements may be presented with the A-plane image710and OV-plane image720, such as a strain graph, a strain image600, area measurements, length measurements, height measurements, ratio measurements, and/or the like. The A-plane image710having the OV-line712and the OV-plane image720having the strain information722may be stored at archive138and/or any suitable data storage medium.

FIG.7is an exemplary display800of a strain graph810and a strain image820, in accordance with various embodiments. Referring toFIG.7, a strain graph810and strain image820may be displayed800at a display system134. The strain graph810may illustrate strain information of various muscle locations over time. The strain image820may be color-coded to illustrate strain values corresponding to different muscle locations. The strain graph810and strain image820may be presented together at the display system134. In an exemplary embodiment, additional measurements may be presented with the strain graph810and strain image820, such as an A-plane image710having the OV-line712, an OV-plane image720having the strain information722, area measurements, length measurements, height measurements, ratio measurements, and/or the like. The strain graph810and strain image820may be stored at archive138and/or any suitable data storage medium.

FIG.8is an exemplary display900of two-dimensional (2D) OV-plane renderings910A,910B at maximal contraction phase910A and maximal Valsalva phase910B, in accordance with various embodiments. Referring toFIG.8, the measurement processor170or an ultrasound operator may select the OV-plane image having the maximal contraction phase910A and the OV-plane image having the maximal Valsalva phase910B. The measurement processor170may be configured to automatically measurement height912A,912B, length914A,914B, and area916A,916B of the contours of the levator hiatus at maximal contraction910A and maximal Valsalva910B. The measurement processor170may be configured to provide ratio measurements between the height912A,912B, length914A,914B, and/or area916A,916B of the maximal contraction910A and maximal Valsalva910B phases. The measurement processor170may be configured to present the measurements912A,912B,914A,914B,916A,916B and corresponding measurement values at the display system134. In an exemplary embodiment, additional measurements may be presented with the area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, and/or ratio measurements, such as an A-plane image710having the OV-line712, an OV-plane image720having the strain information722, a strain image600,820, a strain graph810, and/or the like. The area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, and/or ratio measurements may be stored at archive138and/or any suitable data storage medium.

Referring again toFIG.1, the display system134may be any device capable of communicating visual information to a user. For example, a display system134may include a liquid crystal display, a light emitting diode display, and/or any suitable display or displays. The display system134can be operable to present the A-plane images310,410A,410B,710having the OV-line312,412A,412B,712, the OV-plane images320,420A,420B,720,910A,910B, the OV-plane images320,420A,420B,720,910A,910B overlaid with strain information722, strain images600,820, strain graphs810, the OV-plane images320,420A,420B,720,910A,910B with area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, and/or ratio measurements, and/or any suitable information.

The archive138may be one or more computer-readable memories integrated with the ultrasound system100and/or communicatively coupled (e.g., over a network) to the ultrasound system100, such as a Picture Archiving and Communication System (PACS), a server, a hard disk, floppy disk, CD, CD-ROM, DVD, compact storage, flash memory, random access memory, read-only memory, electrically erasable and programmable read-only memory and/or any suitable memory. The archive138may include databases, libraries, sets of information, or other storage accessed by and/or incorporated with the signal processor132, for example. The archive138may be able to store data temporarily or permanently, for example. The archive138may be capable of storing medical image data, data generated by the signal processor132, and/or instructions readable by the signal processor132, among other things. In various embodiments, the archive138stores ultrasound volumes300, A-plane images310,410A,410B,710, OV-line312,412A,412B,712position and trajectory information, OV-plane images320,420A,420B,720,910A,910B, strain information722, strain images600,820, strain graphs810, area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, ratio measurements, instructions for extracting A-plane images310,410A,410B,710from an ultrasound volume300, instructions for automatically tracking and adjusting an OV-line312,412A,412B,712in A-plane images310,410A,410B,710, instructions for rendering and displaying OV-plane images320,420A,420B,720,910A,910B based on the position and trajectory of the OV-line312,412A,412B,712, instructions for performing and presenting strain measurements600,722,810,820, instructions for performing and presenting area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, and/or ratio measurements, for example.

Components of the ultrasound system100may be implemented in software, hardware, firmware, and/or the like. The various components of the ultrasound system100may be communicatively linked. Components of the ultrasound system100may be implemented separately and/or integrated in various forms. For example, the display system134and the user input device130may be integrated as a touchscreen display.

Still referring toFIG.1, the training system200may comprise a training engine210and a training database220. The training engine210may comprise suitable logic, circuitry, interfaces and/or code that may be operable to train the neurons of the deep neural network(s) (e.g., artificial intelligence model(s)) inferenced (i.e., deployed) by the OV-line processor150. For example, the artificial intelligence model inferenced by the OV-line processor150may be trained to automatically track a position and trajectory of the OV-line312,412A,412B,712in A-plane images310,410A,410B,710over an acquisition time period using database(s)220of classified A-plane images310,410A,410B,710of a pelvic region or any suitable anatomical region (e.g., heart, fetus, or the like).

In various embodiments, the databases220of training images may be a Picture Archiving and Communication System (PACS), or any suitable data storage medium. In certain embodiments, the training engine210and/or training image databases220may be remote system(s) communicatively coupled via a wired or wireless connection to the ultrasound system100as shown inFIG.1. Additionally and/or alternatively, components or all of the training system200may be integrated with the ultrasound system100in various forms.

FIG.9is a flow chart1000illustrating exemplary steps1002-1018that may be utilized for automatically tracking a minimal hiatal dimension plane312,320,412A,420A,412B,420B,712,720,910A,910B of an ultrasound volume300in real-time during a pelvic floor examination, in accordance with various embodiments. Referring toFIG.9, there is shown a flow chart1000comprising exemplary steps1002through1018. Certain embodiments may omit one or more of the steps, and/or perform the steps in a different order than the order listed, and/or combine certain of the steps discussed below. For example, some steps may not be performed in certain embodiments. As a further example, certain steps may be performed in a different temporal order, including simultaneously, than listed below.

At step1002, an ultrasound probe104of an ultrasound system100acquires an ultrasound volume300of an anatomical region over a time period. For example, the ultrasound probe104may be a mechanically wobbling ultrasound probe comprising a one dimensional (1D) array of piezoelectric elements mounted on a transducer assembly movable in a single plane. The ultrasound probe104may be operated in a volume acquisition mode, where the transducer assembly of the mechanically wobbling ultrasound probe104is automatically moved to acquire a plurality of parallel 2D image slices forming the ultrasound volume300, such as an ultrasound volume300of a pelvic region. The ultrasound probe104may sequentially acquire several (e.g., 10-30) ultrasound volumes300over the time period (i.e., 4D acquisition). The ultrasound volumes300may be provided to an A-plane extraction processor140of a signal processor132and/or stored at archive138and/or any suitable data storage medium.

At step1004, a signal processor132of the ultrasound system100may extract, and cause a display system134to present, an A-plane310,410A,410B,510,710from the ultrasound volume300. For example, an A-plane extraction processor140of the signal processor132may be configured to extract and present the A-plane310,410A,410B,510,710from the ultrasound volume300at the display system134.

At step1006, the signal processor132of the ultrasound system100may receive an OmniView (OV) line312,412A,412B,712overlaid on the A-plane310,410A,410B,510,710. For example, an OV-line processor150of the signal processor132may be configured to receive a user positioning of the OV-line312,412A,412B,712superimposed on the A-plane image310,410A,410B,510,710via a user input device130. In a pelvic floor examination, for example, the OV-line312,412A,412B,712may be positioned to extend through the symphysis pubis (SP) and levator ani (LA). The OV-line312,412A,412B,712defines the image data of the ultrasound volume to be rendered to generate an OV-plane320,420A,420B,720,910A,910B. In a pelvic floor examination, the OV-line312,412A,412B,712defines the OV-plane320,420A,420B,720,910A,910B, which corresponds with the minimal hiatal dimension plane. The OV-line processor150may be configured to provide the position and trajectory of the OV-line312,412A,412B,712to an OV-plane rendering processor160of the signal processor132and/or store the position and trajectory of the OV-line312,412A,412B,712and/or the A-plane image310,410A,410B,510,710having the OV-line312,412A,412B,712at archive138and/or any suitable data storage medium.

At step1008, the signal processor132of the ultrasound system100may render and display an OV-plane320,420A,420B,720,910A,910B based on a position and trajectory of the OV-line312,412A,412B,712. For example, an OV-plane rendering processor160of the signal processor132may be configured to render an OV-plane320,420A,420B,720,910A,910B based on the OV-line312,412A,412B,712received from the OV-line processor150and present the rendered OV-plane320,420A,420B,720,910A,910B at the display system134. The OV-plane rendering processor160may render a 2D projection (i.e., the OV-plane image320,420A,420B,720,910A,910B) from a thickness of 1-2 cm of the ultrasound volume300below the OV-line312,412A,412B,712. In a pelvic floor examination, the rendered OV-plane image320,420A,420B,720,910A,910B corresponds with the minimum hiatal distance (MHD) plane of the levator hiatus. The OV-plane rendering processor160may be configured to present the rendered OV-plane image320,420A,420B,720,910A,910B with the corresponding A-plane image310,410A,410B,510,710having the OV-line312,412A,412B,712. For example, the A-plane image310,410A,410B,510,710having the OV-line312,412A,412B,712and the OV-plane image320,420A,420B,720,910A,910B may be presented in a split-screen view at the display system134. The OV-plane rendering processor160may be configured to store the rendered OV-planes320,420A,420B,720,910A,910B at archive138and/or any suitable data storage medium.

At step1010, the signal processor132of the ultrasound system100may automatically identify regions of interest514in the A-plane310,410A,410B,510,710. For example, the OV-line processor150may be configured to automatically identify regions of interest514in the extracted A-plane images510. For example, in a pelvic floor examination, the OV-line312,412A,412B,712is positioned to extend through the symphysis pubis (SP) and levator ani (LA) regions of the pelvic region. The OV-line processor150may be configured to automatically identify the symphysis pubis (SP) and levator ani (LA) as the regions of interest514in the A-plane image510.

At step1012, the signal processor132of the ultrasound system100may automatically select key points516in each of the regions of interest514in the A-plane image310,410A,410B,510,710. For example, the OV-line processor150may be configured to automatically select key points516in the identified regions of interest514. The key points516may correspond with landmarks and/or other trackable features in the A-plane image310,410A,410B,510,710.

At step1014, the signal processor132of the ultrasound system100may automatically track the key points516over the time period to automatically adjust the position and trajectory of the OV-line312,412A,412B,712, the rendering and display of the OV-plane320,420A,420B,720,910A,910B automatically updating over the time period based on the adjustments of the position and trajectory of the OV-line312,412A,412B,712. For example, the OV-line processor150may be configured to automatically track the regions of interest514and key points516in subsequently acquired A-plane images310,410A,410B,510,710to adjust the position and trajectory of an OV-line312,412A,412B,712. In this regard, the OV-line processor150may include, for example, artificial intelligence image analysis algorithms, computer vision algorithms, one or more deep neural networks (e.g., a convolutional neural network such as u-net) and/or may utilize any suitable form of image analysis techniques or machine learning processing functionality configured to track a position and trajectory of the OV-line312,412A,412B,712in A-plane images310,410A,410B,510,710over an acquisition time period. The OV-plane rendering processor160continues to render and present the OV-plane image320,420A,420B,720,910A,910B based on any automatic adjustments to the position and trajectory of the OV-line312,412A,412B,712during the acquisition time period.

At step1016, the signal processor132of the ultrasound system100may perform at least one measurement600,722,810,820,912A,912B,914A,914B,916A,916B. For example, a measurement processor170of the signal processor132may be configured to perform measurements of one or more of the OV-plane images320,420A,420B,720,910A,910B rendered and presented during the examination time period. As an example, the measurement processor170may be configured to compute strain of pelvic floor muscles in the OV-plane image320,420A,420B,720,910A,910B of the levator hiatus. The ultrasound signals in the OV-plane320,420A,420B,720,910A,910B may be tracked to compute the strain based on speckle tracking or direct strain computation (e.g., where displacements of small signal segments between two frames are first estimated, and then strains are obtained by taking the derivatives of the displacements), for example. The measurement processor170may be configured to generate a strain image600,820, a graph of the strain values810, and/or may overlay the strain information722(e.g., color-coded) on the OV-plane image320,420A,420B,720,910A,910B. In various embodiments, the measurement processor170may be configured to inference a pelvic floor disorder risk artificial intelligence model to generate a predicted risk. As another example, the measurement processor170may be configured to compute area916A,916B, length914A,914B, height912A,912B, and ratios based on the contours of the levator hiatus (e.g., contours of the levator hiatus at maximal contraction and maximal Valsalva).

At step1018, the signal processor132of the ultrasound system100may cause the display system132to display the at least one measurement600,722,810,820,912A,912B,914A,914B,916A,916B. For example, the measurement processor170may be configured to cause the display system134to present a strain image600,820, an OV-plane image320,420A,420B,720,910A,910B overlaid with strain information722, a strain graph810, a predicted risk, area measurements916A,916B, length measurements914A,914B, height measurements912A,912B, ratio measurements, and/or any suitable measurement(s).

Aspects of the present disclosure provide a method1000and system100for automatically tracking a minimal hiatal dimension plane312,320,412A,420A,412B,420B,712,720,910A,910B of an ultrasound volume300in real-time during a pelvic floor examination. In accordance with various embodiments, the method1000may comprise acquiring1002, by a probe104of an ultrasound system100, an ultrasound volume300of an anatomical region over a time period. The method1000may comprise extracting1004, by at least one processor132,140of the ultrasound system100, an A-plane image310,410A,410B,510,710from the ultrasound volume100. The A-plane image310,410A,410B,510,710is presented at a display system134of the ultrasound system100. The method1000may comprise receiving1006, by the at least one processor132,150, an OmniView (OV) line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710. The method1000may comprise rendering1008, by the at least one processor132,160, an OV-plane image320,420A,420B,720,910A,910B based on a position and trajectory of the OV-line312,412A,412B,712. The OV-plane image320,420A,420B,720,910A,910B is presented at the display system134. The method1000may comprise automatically identifying1010,1012, by the at least one processor132,150, key points516in regions of interest514in the A-plane image310,410A,410B,510,710. The method1000may comprise automatically tracking1014, by the at least one processor132,150, the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period to automatically adjust the position and trajectory of the OV-line312,412A,412B,712. The rendering the OV-plane image320,420A,420B,720,910A,910B automatically updates over the time period based on adjustments of the position and trajectory of the OV-line312,412A,412B,712.

In a representative embodiment, the anatomical region is a pelvic region. The OV-line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710may pass through a symphysis pubis and levator ani of the pelvic region. In an exemplary embodiment, the regions of interest514in the A-plane image310,410A,410B,510,710comprise the symphysis pubis and the levator ani. The OV-plane image320,420A,420B,720,910A,910B may correspond to a minimum hiatus distance plane312,320,412A,420A,412B,420B,712,720,910A,910B. In various embodiments, the automatically identifying1010,1012key points516in the regions of interest514in the A-plane image310,410A,410B,510,710and/or the automatically tracking1014the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period is performed by the at least one processor132,150executing artificial intelligence. In certain embodiments, the automatically tracking1014the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period is performed by the at least one processor executing computer vision. In a representative embodiment, the method1000comprises computing1016, by the at least one processor132,170, strain based on speckle tracking or direct strain computation. The method1000may comprise causing, by the at least one processor132,170, the display system134to present1018a strain image600,820, the strain722overlaid on the OV-plane image320,420A,420B,720,910A,910B, and/or a strain graph810of the strain over time. In an exemplary embodiment, the method1000comprises computing1016, by the at least one processor132,170, at least one measurement600,722,810,820,912A,912B,914A,914B,916A,916B comprising an area measurement916A,916B, a length measurement914A,914B, a height measurement912A,912B, and/or a ratio measurement at maximal contraction phase910A and maximum Valsalva phase910B. The method1000may comprise causing, by the at least one processor132,170, the display system134to present1018the measurement600,722,810,820,912A,912B,914A,914B,916A,916B.

Various embodiments provide a system100for automatically tracking a minimal hiatal dimension plane312,320,412A,420A,412B,420B,712,720,910A,910B of an ultrasound volume300in real-time during a pelvic floor examination. The ultrasound system100may comprise a probe104, at least one processor132,140,150,160,170and a display system134. The ultrasound probe104may be operable to acquire an ultrasound volume300of an anatomical region over a time period. The at least one processor132,140may be configured to extract an A-plane image310,410A,410B,510,710from the ultrasound volume300. The at least one processor132,150may be configured to receive an OmniView (OV) line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710. The at least one processor132,160may be configured to render an OV-plane image320,420A,420B,720,910A,910B based on a position and trajectory of the OV-line312,412A,412B,712. The at least one processor132,150may be configured to automatically identify key points516in regions of interest514in the A-plane image310,410A,410B,510,710. The at least one processor132,150may be configured to automatically track the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period to automatically adjust the position and trajectory of the OV-line312,412A,412B,712. The at least one processor132,160is configured to automatically update the OV-plane image320,420A,420B,720,910A,910B over the time period based on adjustments of the position and trajectory of the OV-line312,412A,412B,712. The display system134may be configured to present the A-plane image310,410A,410B,510,710, the OV-line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710, and the OV-plane image320,420A,420B,720,910A,910B.

In an exemplary embodiment, the anatomical region is a pelvic region. The OV-line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710may pass through a symphysis pubis and levator ani of the pelvic region. In various embodiments, the regions of interest in the A-plane image310,410A,410B,510,710comprise the symphysis pubis and the levator ani. The OV-plane image320,420A,420B,720,910A,910B may correspond to a minimum hiatus distance plane312,320,412A,420A,412B,420B,712,720,910A,910B. In certain embodiments, the at least one processor132,150is configured to execute artificial intelligence to perform the automatically identifying key points516in the regions of interest514in the A-plane image310,410A,410B,510,710and/or the automatically tracking the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period. In a representative embodiment, the at least one processor132,150is configured to apply computer vision to perform the automatically tracking the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period. In an exemplary embodiment, the at least one processor132,170is configured to compute strain based on speckle tracking or direct strain computation. The at least one processor132,170is configured to cause the display system134to present a strain image600,820, the strain722overlaid on the OV-plane image320,420A,420B,720,910A,910B, and/or a strain graph810of the strain over time. In various embodiments, the at least one processor132,170is configured to compute at least one measurement600,722,810,820,912A,912B,914A,914B,916A,916B comprising an area measurement916A,916B, a length measurement914A,914B, a height measurement912A,912B, and/or a ratio measurement at maximal contraction phase910A and maximum Valsalva phase910B. The at least one processor132,170is configured to cause the display system134to present the measurement600,722,810,820,912A,912B,914A,914B,916A,916B.

Certain embodiments provide a non-transitory computer readable medium having stored thereon, a computer program having at least one code section. The at least one code section is executable by a machine for causing an ultrasound system100to perform steps1000. The steps1000may comprise receiving1002an ultrasound volume300of an anatomical region over a time period. The steps1000may comprise extracting1004an A-plane image310,410A,410B,510,710from the ultrasound volume300. The A-plane image310,410A,410B,510,710is presented at a display system134of the ultrasound system100. The steps1000may comprise receiving1006an OmniView (OV) line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710. The steps1000may comprise rendering1008an OV-plane image320,420A,420B,720,910A,910B based on a position and trajectory of the OV-line312,412A,412B,712. The OV-plane image320,420A,420B,720,910A,910B is presented at the display system134. The steps1000may comprise automatically identifying1010,1012key points516in regions of interest514in the A-plane image310,410A,410B,510,710. The steps1000may comprise automatically tracking1014the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period to automatically adjust the position and trajectory of the OV-line312,412A,412B,712. The rendering1008the OV-plane image320,420A,420B,720,910A,910B automatically updates over the time period based on adjustments of the position and trajectory of the OV-line312,412A,412B,712.

In various embodiments, the anatomical region is a pelvic region. The OV-line312,412A,412B,712overlaid on the A-plane image310,410A,410B,510,710passes through a symphysis pubis and levator ani of the pelvic region. The regions of interest in the A-plane image310,410A,410B,510,710comprise the symphysis pubis and the levator ani. The OV-plane image320,420A,420B,720,910A,910B corresponds to a minimum hiatus distance plane312,320,412A,420A,412B,420B,712,720,910A,910B. In certain embodiments, the automatically identifying1010,1012key points516in the regions of interest514in the A-plane image310,410A,410B,510,710and/or the automatically tracking1014the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period is performed by executing artificial intelligence. In a representative embodiment, the automatically tracking1014the key points516in the regions of interest514in the A-plane image310,410A,410B,510,710over the time period is performed by executing computer vision. In an exemplary embodiment, the steps1000may comprise computing1016strain based on speckle tracking or direct strain computation. The steps1000may comprise causing the display system134to present1018a strain image600,820, the strain722overlaid on the OV-plane image320,420A,420B,720,910A,910B, and/or a strain graph810of the strain over time. In various embodiments, the steps1000may comprise computing1016at least one measurement600,722,810,820,912A,912B,914A,914B,916A,916B comprising an area measurement916A,916B, a length measurement914A,914B, a height measurement912A,912B, and/or a ratio measurement at maximal contraction phase910A and maximum Valsalva phase910B. The steps1000may comprise causing the display system134to present the measurement600,722,810,820,912A,912B,914A,914B,916A,916B.

Other embodiments may provide a computer readable device and/or a non-transitory computer readable medium, and/or a machine readable device and/or a non-transitory machine readable medium, having stored thereon, a machine code and/or a computer program having at least one code section executable by a machine and/or a computer, thereby causing the machine and/or computer to perform the steps as described herein for automatically tracking a minimal hiatal dimension plane of an ultrasound volume in real-time during a pelvic floor examination.

Accordingly, the present disclosure may be realized in hardware, software, or a combination of hardware and software. The present disclosure may be realized in a centralized fashion in at least one computer system, or in a distributed fashion where different elements are spread across several interconnected computer systems. Any kind of computer system or other apparatus adapted for carrying out the methods described herein is suited.