Estimation and tracking of AP-diameter of the inferior vena cava in ultrasound images using a novel active circle algorithm

Medical research suggests that the anterior-posterior (AP)-diameter of the inferior vena cava (IVC) and its associated temporal variation as imaged by bedside ultrasound is useful in guiding fluid resuscitation of the critically-ill patient. Unfortunately, indistinct edges and gaps in vessel walls are frequently present which impede accurate estimation of the IVC AP-diameter for both human operators and segmentation algorithms. The majority of research involving use of the IVC to guide fluid resuscitation involves manual measurement of the maximum and minimum AP-diameter as it varies over time. This effort proposes using a time-varying circle fitted inside the typically ellipsoid IVC as an efficient, consistent and novel approach to tracking and approximating the AP-diameter even in the context of poor image quality. In this active-circle algorithm, a novel evolution functional is proposed and shown to be a useful tool for ultrasound image processing. The proposed algorithm is compared with an expert manual measurement, and state-of-the-art relevant algorithms. It is shown that the algorithm outperforms other techniques and performs very close to manual measurement.