Measuring proximity to standard planes during fetal brain ultrasound scanning

This paper presents a pipeline designed to bring ultrasound (US) plane pose estimation closer to clinical use, demonstrating the feasibility of continuous, real-time proximity feedback for navigation to the standard planes (SPs) in the fetal brain. We propose a semi-supervised segmentation model that uses labeled SPs and unlabeled slices from 3D US volumes (non-SPs), achieving 0.93 mean Intersection over Union (mIoU) on SPs and 0.86 mIoU on arbitrary non-SPs. The model incorporates a classification mechanism to identify and filter out frames lacking the fetal brain, and to generate masks for those containing it, enhancing the relevance of plane pose regression in clinical settings. Combined with 6D plane pose regression, our pipeline provides sensorless, continuous proximity detection to SPs with real-time distance metrics rather than binary plane recognition. Furthermore, we validate its translational viability by deploying the system on an NVIDIA Clara AGX edge device, achieving a real-time inference speed of 39 Hz, which exceeds standard clinical acquisition rates. Unlike prior methods validated on curated volume slices, we evaluate the pipeline retrospectively on real fetal scan videos from 17 sonographers of varying expertise: operators freeze near, rather than exactly at, the local minima of the proximity signal, consistent with clinical freeze-timing behavior, whereas proximity alone does not predict expert SP quality scores. The approach complements existing fetal US technologies and is a step toward image-based navigation support in prenatal scanning.