Improving placenta imaging in women living with HIV

出生时胎盘图像快速评估软件的开发 项目摘要 胎盘是了解怀孕事件以及母亲和婴儿健康的窗口，但只有大约 在美国，20%的胎盘通过病理学检查进行评估，胎盘数据通常被忽视， 怀孕研究由于母亲和胎儿都有助于并调节胎盘发育， 胎盘检查的数据可以为母亲和母亲的短期和长期临床护理提供信息， 孩子胎盘病理学由于所需的时间、成本、专业知识和设施而仍然未得到充分利用，即使在 高资源设置。胎盘评估可以而且应该更容易被病理学家，临床医生， 出生时的评估可以更容易地帮助临床决策，并将发现与 患者先前的工作使用摄影图像来测量形状和绳索盘绕等特征 并将这些特征与胎盘诊断和具有临床重要性的结果相关联。这个项目 旨在利用数字照片的简单性和低成本以及计算和决策 人工智能（AI）最新进展的力量，为全面的胎盘 根据胎盘的图像进行评估。该软件可以满足广泛，简单 胎盘评估，特别是当迫切需要信息时，病理学家没有受过高度培训， 胎盘病理学，或者资源仅允许审查一小部分胎盘。的 研究团队，在胎盘病理学和研究，临床护理，医疗 信息学/人工智能和图像理解已经开发出了一个初步的原型，并取得了可喜的成果， 预测了几个有临床影响力的诊断。我们的初步数据表明，广泛的数据可以 从胎盘照片中收集，并且计算技术允许将抽象数据连接起来 来鉴别胎盘疾病本提案的目标是开发和验证软件，以评估 从数字照片中提取胎盘。一个广泛的，第一次的数据集将是 从三家大医院创建，包括图像和专家病理报告， 异常和健康结果（n> 50，000）。这些网站包括一系列的特点，收入， 种族/民族、健康风险和医院资源。由此产生的软件将收集视觉特征 从椎间盘，脊髓，和膜中准确识别特定特征（例如，形状）和诊断 (e.g.,绒毛膜炎）。即时信息可能会影响出院前的临床护理， 易于使用将允许纳入妊娠研究。该软件有能力加强传统的 通过标准化和增强收集的数据，提供更好的信息， 病理学家随着技术的巨大进步，出生时的胎盘评估不再被视为 不重要或太难当在一系列分娩环境中得到充分发展和临床验证时， 软件有能力影响全世界数百万母亲和儿童的护理。

Development of Software to Rapidly Assess Placenta Images at Birth Project Summary The placenta is a window into the events of pregnancy and the health of the mother and baby, yet only about 20% of placentas in the US are assessed by pathology exams and placental data is often neglected in pregnancy research. Since both the mother and fetus contribute to and modulate placental development and function, data from placental examination may inform short- and long-term clinical care of both mother and child. Placental pathology remains under-used due to the time, cost, expertise, and facilities needed, even in high-resource settings. Placental assessment can and should be more accessible to pathologists, clinicians, and researchers, and assessment at birth can more readily aid clinical decisions and relate findings to patients. Prior work has used photographic images to measure characteristics such as shape and cord coiling and related these characteristics to placental diagnoses and outcomes of clinical importance. This project aims to leverage the simplicity and low cost of digital photographs and the computational and decision power of recent advances in artificial intelligence (AI) to create software for comprehensive placental assessment from images of gross placentas. The software could address the need for widespread, simple placenta assessment, particularly when information is needed urgently, pathologists are not highly trained for placental pathology, or where resources only allow a small fraction of placentas to be reviewed. The investigative team, with extensive expertise in placental pathology and research, clinical care, medical informatics/AI, and image understanding, has developed an initial prototype with promising results for predicting several clinically impactful diagnoses. Our preliminary data demonstrates that extensive data can be collected from placental photos and that computational techniques allow the connection of abstracted data to identify placental disease. The goal of this proposal is to develop and validate software to assess placentas from digital photographs in any delivery setting. An extensive, first-of-its-kind dataset will be created from three large hospitals including images and expert pathology reports from pregnancies with abnormal and healthy outcomes (n>50,000). These sites include a range of characteristics across income, race/ethnicity, health risks, and hospital resources. The resulting software will glean visual characteristics from the disc, cord, and membranes and accurately identify specific features (e.g., shape) and diagnoses (e.g., chorioamnionitis). The immediate information could impact clinical care before hospital discharge, and ease-of-use will allow inclusion in pregnancy research. This software has the ability to strengthen traditional pathology exams by standardizing and enhancing the data collected, providing better information to pathologists. With such huge advances in technology, placental assessment at birth can no longer be viewed as nonessential or too difficult. When fully developed and validated clinically in a range of birth settings, this software could have the power to impact the care of millions of mothers and children around the world.