Automatic measurement of kidney dimensions in two-dimensional ultrasonography is comparable to expert sonographers.

ABSTRACT

Purpose: Length and width measurements of the kidneys aid in the detection and monitoring of structural abnormalities and organ disease. Manual measurement results in intra- and inter-rater variability, is complex and time-consuming, and is fraught with error. We propose an automated approach based on machine learning for quantifying kidney dimensions from two-dimensional (2D) ultrasound images in both native and transplanted kidneys. Approach: An nnU-net machine learning model was trained on 514 images to segment the kidney capsule in standard longitudinal and transverse views. Two expert sonographers and three medical students manually measured the maximal kidney length and width in 132 ultrasound cines. The segmentation algorithm was then applied to the same cines, region fitting was performed, and the maximum kidney length and width were measured. Additionally, single kidney volume for 16 patients was estimated using either manual or automatic measurements. Results: The experts resulted in length of 84.8±26.4 mm [95% CI 80.0, 89.6] and a width of 51.8±10.5 mm [49.9, 53.7]. The algorithm resulted a length of 86.3±24.4 [81.5, 91.1] and a width of 47.1±12.8 [43.6, 50.6]. Experts, novices, and the algorithm did not statistically significant differ from one another (p>0.05). Bland-Altman analysis showed the algorithm produced a mean difference of 2.6 mm (SD = 1.2) from experts, compared to novices who had a mean difference of 3.7 mm (SD = 2.9 mm). For volumes, mean absolute difference was 47 mL (31%) consistent with ∼1 mm error in all three dimensions. Conclusions: This pilot study demonstrates the feasibility of an automatic tool to measure in vivo kidney biometrics of length, width, and volume from standard 2D ultrasound views with comparable accuracy and reproducibility to expert sonographers. Such a tool may enhance workplace efficiency, assist novices, and aid in tracking disease progression.