{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:54:08Z","timestamp":1784868848956,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T00:00:00Z","timestamp":1522627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Erasmus+ Programme of the European Union","award":["Framework Agreement number: 2013-0040"],"award-info":[{"award-number":["Framework Agreement number: 2013-0040"]}]},{"name":"\u2018la Caixa\u2019 Foundation"},{"name":"Cerebra Foundation for the Brain Injured Child"},{"name":"AGAUR 2014 SGR","award":["grant number 928"],"award-info":[{"award-number":["grant number 928"]}]},{"name":"\u2018la Secretaria d\u2019Universitats i Recerca del Departament d'Economia i Coneixement de la Generalitat de Catalunya'","award":["(A.P.: 2014DI083)"],"award-info":[{"award-number":["(A.P.: 2014DI083)"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>New tools are required to improve the identification of women who are at increased risk for spontaneous preterm birth (sPTB). Quantitative analysis of tissue texture on ultrasound has been used to extract robust features from the ultrasound image to detect subtle changes in its microstructure. This may be applied to the cervix. The aim of this study was to determine if there is an association between quantitative analysis of cervical texture (CTx) on mid\u2010trimester ultrasound and sPTB &lt;\u200937\u2009+\u20090\u2009weeks' gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center nested case\u2013control study of a prospective cohort of 677 consecutive women with singleton pregnancy assessed between 19\u2009+\u20090 and 24\u2009+\u20096\u2009weeks' gestation. Women at increased risk for sPTB were included unless they received treatment to prevent sPTB. Women who delivered &lt;\u200937\u2009+\u20090\u2009weeks (sPTB) were considered as cases and were matched in a 1: 10 ratio with randomly selected contemporary controls who delivered at term. For each woman, one ultrasound image of the cervix was obtained for which quality was assessed, cervical length (CL) measured offline and a region of interest in the midportion of the anterior cervical lip delineated for use in local binary patterns analysis of CTx. A learning algorithm was developed to obtain the combination of CTx features best associated with sPTB based on feature transformation and discriminant analysis regression. The ability of the learning algorithm to predict sPTB was evaluated using a leave\u2010one\u2010out cross\u2010validation technique, which produced a CTx\u2010based score for each participant. Receiver\u2013operating characteristics (ROC) curves were produced and sensitivity, specificity, and positive and negative likelihood ratios were calculated for the optimal cut\u2010off based on the ROC curve. The results were compared with those obtained for CL. Investigators studying the images were blinded to pregnancy outcome at all times.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Images from 310 women (27 cases and 283 controls) were of sufficient quality and included in the study. Median CTx\u2010based score was significantly lower in cases compared with controls (\u22121.01 <jats:italic>vs<\/jats:italic> \u22120.07, <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.0001). CTx\u2010based score maintained its significant association with sPTB after adjusting for possible confounders (history of sPTB, conization or M\u00fcllerian malformation, and CL\u2009&lt;\u200925\u2009mm). CTx\u2010based score was a better predictor of sPTB (AUC, 0.77; 95% CI, 0.66\u20130.87) than was CL (AUC, 0.60; 95% CI, 0.47\u20130.72) (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). Median CL was similar for cases and controls (37.7 <jats:italic>vs<\/jats:italic> 38.6\u2009mm, <jats:italic>P<\/jats:italic>\u2009=\u20090.26), although cases were more likely to have CL\u2009&lt;\u200925\u2009mm (18.5% <jats:italic>vs<\/jats:italic> 0.4%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Quantitative analysis of CTx enables the extraction of information relevant to sPTB from ultrasound images to generate a CTx\u2010based score that is associated independently with sPTB. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.17525","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T01:36:39Z","timestamp":1494898599000},"page":"637-643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Quantitative analysis of cervical texture by ultrasound in mid\u2010pregnancy and association with spontaneous preterm birth"],"prefix":"10.1002","volume":"51","author":[{"given":"N.","family":"Ba\u00f1os","sequence":"first","affiliation":[{"name":"Fetal i+D Fetal Medicine Research Center, BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine, Hospital Cl\u00ednic and Hospital Sant Joan de Deu, Institut Cl\u00ednic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer Universitat de Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Perez\u2010Moreno","sequence":"additional","affiliation":[{"name":"Transmural Biotech S. 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