{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:15:44Z","timestamp":1789064144348,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["ERC\u2010ADG\u20102015 694581"],"award-info":[{"award-number":["ERC\u2010ADG\u20102015 694581"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Despite decades of obstetric scanning, the field of sonographer workflow remains largely unexplored. In the second trimester, sonographers use scan guidelines to guide their acquisition of standard planes and structures; however, the scan\u2010acquisition order is not prescribed. Using deep\u2010learning\u2010based video analysis, the aim of this study was to develop a deeper understanding of the clinical workflow undertaken by sonographers during second\u2010trimester anomaly scans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected prospectively full\u2010length video recordings of routine second\u2010trimester anomaly scans. Important scan events in the videos were identified by detecting automatically image freeze and image\/clip save. The video immediately preceding and following the important event was extracted and labeled as one of 11 commonly acquired anatomical structures. We developed and used a purposely trained and tested deep\u2010learning annotation model to label automatically the large number of scan events. Thus, anomaly scans were partitioned as a sequence of anatomical planes or fetal structures obtained over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 496 anomaly scans performed by 14 sonographers were available for analysis. UK guidelines specify that an image or videoclip of five different anatomical regions must be stored and these were detected in the majority of scans: head\/brain was detected in 97.2% of scans, coronal face view (nose\/lips) in 86.1%, abdomen in 93.1%, spine in 95.0% and femur in 92.3%. Analyzing the clinical workflow, we observed that sonographers were most likely to begin their scan by capturing the head\/brain (in 24.4% of scans), spine (in 23.2%) or thorax\/heart (in 22.8%). The most commonly identified two\u2010structure transitions were: placenta\/amniotic fluid to maternal anatomy, occurring in 44.5% of scans; head\/brain to coronal face (nose\/lips) in 42.7%; abdomen to thorax\/heart in 26.1%; and three\u2010dimensional\/four\u2010dimensional face to sagittal face (profile) in 23.7%. Transitions between three or more consecutive structures in sequence were uncommon (up to 13% of scans). None of the captured anomaly scans shared an entirely identical sequence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We present a novel evaluation of the anomaly scan acquisition process using a deep\u2010learning\u2010based analysis of ultrasound video. We note wide variation in the number and sequence of structures obtained during routine second\u2010trimester anomaly scans. Overall, each anomaly scan was found to be unique in its scanning sequence, suggesting that sonographers take advantage of the fetal position and acquire the standard planes according to their visibility rather than following a strict acquisition order. \u00a9 2022 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.24975","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T03:44:42Z","timestamp":1655783082000},"page":"759-765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Clinical workflow of sonographers performing fetal anomaly ultrasound scans: deep\u2010learning\u2010based analysis"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5588-1410","authenticated-orcid":false,"given":"L.","family":"Drukker","sequence":"first","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford  Oxford UK"},{"name":"Women's Ultrasound, Department of Obstetrics and Gynecology Beilinson Medical Center, Sackler Faculty of Medicine, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-2606","authenticated-orcid":false,"given":"H.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-6283","authenticated-orcid":false,"given":"J. N.","family":"Karim","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8030-3321","authenticated-orcid":false,"given":"R.","family":"Droste","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3060-3772","authenticated-orcid":false,"given":"J. A.","family":"Noble","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8143-2232","authenticated-orcid":false,"given":"A. T.","family":"Papageorghiou","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15343"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.06.033"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/8756479319838234"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2013.32.5.847"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ergon.2009.11.005"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17246"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-1812-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24888"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14831"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22122"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21967"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21929"},{"key":"e_1_2_8_15_1","unstructured":"Public Health England.Fetal anomaly screening programme: standards.https:\/\/www.gov.uk\/government\/publications\/fetal\u2010anomaly\u2010screening\u2010programme\u2010standards."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-92829-1"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15819"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181dd5137"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1074-0722"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2021.101973"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15188"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1388366"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.15030"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-70159-y"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2017.2712367"},{"key":"e_1_2_8_26_1","doi-asserted-by":"crossref","unstructured":"MaraciMA NapolitanoR PapageorghiouA NobleJA.Fisher vector encoding for detecting objects of interest in ultrasound videos. IEEE 12thInternational Symposium on Biomedical Imaging (ISBI) 2015;651\u2013654.","DOI":"10.1109\/ISBI.2015.7163957"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24574-4_82"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1109\/TCYB.2017.2685080"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-67076-5"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24843"},{"key":"e_1_2_8_31_1","unstructured":"Centre for Workforce Intelligence.Sonography workforce supply review.https:\/\/www.gov.uk\/government\/publications\/review\u2010of\u2010the\u2010sonography\u2010workforce\u2010supply."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00244"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.12547"},{"issue":"615","key":"e_1_2_8_34_1","first-page":"e1","article-title":"Utility of follow\u2010up standard sonography for fetal anomaly detection","volume":"222","author":"Byrne JJ","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.04.248"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24975","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.24975","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24975","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T08:41:44Z","timestamp":1779093704000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.24975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1002\/uog.24975"],"URL":"https:\/\/doi.org\/10.1002\/uog.24975","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"2022-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}