{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T05:02:07Z","timestamp":1784437327419,"version":"3.55.0"},"reference-count":42,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cabinet Office BRIDGE Program for Bridging the Gap Between R&D and the Ideal Society"},{"name":"Generating Economic and Social Value"},{"name":"JST SPRING","award":["JPMJSP2180"],"award-info":[{"award-number":["JPMJSP2180"]}]},{"DOI":"10.13039\/501100001691","name":"JSPS Grants-in-Aid for Scientific Research","doi-asserted-by":"crossref","award":["JP21K09456"],"award-info":[{"award-number":["JP21K09456"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"JSPS Grants-in-Aid for Scientific Research","doi-asserted-by":"crossref","award":["JP25K15973"],"award-info":[{"award-number":["JP25K15973"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"JSPS Grants-in-Aid for Scientific Research","doi-asserted-by":"crossref","award":["JP24K12634"],"award-info":[{"award-number":["JP24K12634"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Cancer Center Research and Development Fund","award":["2023-A-04"],"award-info":[{"award-number":["2023-A-04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Total anomalous pulmonary venous connection (TAPVC) is a severe congenital heart disease, yet its prenatal detection rate remains suboptimal. To support prenatal ultrasound screening of TAPVC, the post-left atrium space (PLAS) index and the left-atrial posterior-space-to-diagonal (LAPSD) ratio measured in the four-chamber view (4CV) have been proposed as useful biometric parameters. In this study, we developed a novel approach that integrates automated 4CV extraction (AE) from fetal cardiac ultrasound videos with automated measurement of these indices. The heart, crux, and descending aorta were segmented using DeepLabv3+, UNet3+, and SegFormer. The screening performance of the AE-based methods was comparable to that of manual 4CV extraction, as demonstrated by similar mean areas under the receiver operating characteristic curve (AUCs). In a clinical comparison study, the mean AUC values for residents, fellows, experts, AE-DeepLabv3+, AE-UNet3+, and AE-SegFormer were 0.784, 0.801, 0.996, 0.903, 0.928, and 0.940, respectively, for the PLAS index and 0.797, 0.801, 0.996, 0.919, 0.916, and 0.940, respectively, for the LAPSD ratio. Although experts demonstrated the best overall performance, the fully automated methods consistently outperformed both the residents and fellows. This approach may support less experienced examiners, improve screening accuracy, streamline clinical workflows, and ultimately enhance the prenatal detection of TAPVC.<\/jats:p>","DOI":"10.3390\/bioengineering13070822","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:32:17Z","timestamp":1784266337000},"page":"822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fully Automated Biometric Parameter Measurement in Prenatal Ultrasound Screening for Total Anomalous Pulmonary Venous Connection"],"prefix":"10.3390","volume":"13","author":[{"given":"Rina","family":"Aoyama","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoaki","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of NCC Cancer Science, Biomedical Science and Engineering Track, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan"},{"name":"Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"},{"name":"Digital Health Platform Development Office, Healthcare Business Unit, Fujitsu Japan Ltd., 1-5 Omiya-cho, Saiwai-ku, Kawasaki 212-0014, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0421-8085","authenticated-orcid":false,"given":"Masaaki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, 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Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"},{"name":"AI Medical Engineering Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1296-8152","authenticated-orcid":false,"given":"Naoki","family":"Teraya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-4449","authenticated-orcid":false,"given":"Ken","family":"Asada","sequence":"additional","affiliation":[{"name":"Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"},{"name":"AI Medical Engineering Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-9800","authenticated-orcid":false,"given":"Syuzo","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"},{"name":"AI Medical Engineering Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Digital Health Platform Development Office, Healthcare Business Unit, Fujitsu Japan Ltd., 1-5 Omiya-cho, Saiwai-ku, Kawasaki 212-0014, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-4145","authenticated-orcid":false,"given":"Ryu","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2249-1333","authenticated-orcid":false,"given":"Akihiko","family":"Sekizawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2632-1334","authenticated-orcid":false,"given":"Ryuji","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of NCC Cancer Science, Biomedical Science and Engineering Track, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan"},{"name":"Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"},{"name":"AI Medical Engineering Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","first-page":"1344","article-title":"Outcome of congenital heart defects\u2014A population-based study","volume":"89","author":"Meberg","year":"2000","journal-title":"Acta Paediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1001\/jamacardio.2018.2009","article-title":"Live-born major congenital heart disease in Denmark: Incidence, detection rate, and termination of pregnancy rate from 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