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Jenna Lowe and Erin Curry

demonstrated that ultrasonography is an effective method to diagnose and monitor pregnancy in A. f. styani and, in one pregnancy, enabled the documentation of fetal loss post-implantation ( Curry et al. 2017 ); however, the overall rate of pregnancy loss

Open access

Gabriel Maicas, Mathew Leonardi, Jodie Avery, Catrina Panuccio, Gustavo Carneiro, M Louise Hull, and George Condous


Pouch of Douglas (POD) obliteration is a severe consequence of inflammation in the pelvis, often seen in patients with endometriosis. The sliding sign is a dynamic transvaginal ultrasound (TVS) test that can diagnose POD obliteration. We aimed to develop a deep learning (DL) model to automatically classify the state of the POD using recorded videos depicting the sliding sign test.


Two expert sonologists performed, interpreted, and recorded videos of consecutive patients from September 2018 to April 2020. The sliding sign was classified as positive (i.e. normal) or negative (i.e. abnormal; POD obliteration). A DL model based on a temporal residual network was prospectively trained with a dataset of TVS videos. The model was tested on an independent test set and its diagnostic accuracy including area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive value (PPV/NPV) was compared to the reference standard sonologist classification (positive or negative sliding sign).


In a dataset consisting of 749 videos, a positive sliding sign was depicted in 646 (86.2%) videos, whereas 103 (13.8%) videos depicted a negative sliding sign. The dataset was split into training (414 videos), validation (139), and testing (196) maintaining similar positive/negative proportions. When applied to the test dataset using a threshold of 0.9, the model achieved: AUC 96.5% (95% CI: 90.8–100.0%), an accuracy of 88.8% (95% CI: 83.5–92.8%), sensitivity of 88.6% (95% CI: 83.0–92.9%), specificity of 90.0% (95% CI: 68.3–98.8%), a PPV of 98.7% (95% CI: 95.4–99.7%), and an NPV of 47.7% (95% CI: 36.8–58.2%).


We have developed an accurate DL model for the prediction of the TVS-based sliding sign classification.

Lay summary

Endometriosis is a disease that affects females. It can cause very severe scarring inside the body, especially in the pelvis − called the pouch of Douglas (POD). An ultrasound test called the 'sliding sign' can diagnose POD scarring. In our study, we provided input to a computer on how to interpret the sliding sign and determine whether there was POD scarring or not. This is a type of artificial intelligence called deep learning (DL). For this purpose, two expert ultrasound specialists recorded 749 videos of the sliding sign. Most of them (646) were normal and 103 showed POD scarring. In order for the computer to interpret, both normal and abnormal videos were required. After providing the necessary inputs to the computer, the DL model was very accurate (almost nine out of every ten videos was correctly determined by the DL model). In conclusion, we have developed an artificial intelligence that can interpret ultrasound videos of the sliding sign that show POD scarring that is almost as accurate as the ultrasound specialists. We believe this could help increase the knowledge on POD scarring in people with endometriosis.

Open access

Chris R Burke, John R Roche, Robert P Millar, and Iain J Clarke

18–25 days postpartum were initially enrolled to the study conducted at the DairyNZ Scott Research Farm, Hamilton, New Zealand. The development of ovarian follicles was monitored daily at 8:00 h by transrectal ultrasonography (5–15 MHz probe

Open access

Roberto Rodrigues da Rosa Filho, Maíra Morales Brito, Thaís Gomes Faustino, Leticia Lima de Almeida, Verônica Correia Manoel, Bruno Cogliati, and Camila Infantosi Vannucchi

variables: uterine area, qualitative evaluation of the endometrial vasculature and blood NO, comparisons among groups were evaluated by ANOVA test. For PW Doppler ultrasonography, immunohistochemistry and stereology, data were evaluated according to a double

Open access

Nick Wheelhouse, Sadie Kemp, Jo E B Halliday, Efstathios Alexandros Tingas, W Colin Duncan, and Andrew W Horne

previously described ( Horne et al . 2020 ). Briefly, we recruited women with ultrasonography confirming the absence of a fetal heart in the first trimester of pregnancy (miscarriage group) and women with normal pregnancies that had progressed into the third

Open access

Meaghan J Griffiths, Lauren R Alesi, Amy L Winship, and Karla J Hutt

after conclusion of ultrasound imaging, and then uteri were carefully dissected out and formalin was fixed for further analysis. Doppler ultrasonography At 10 days post ET, recipient females were anaesthetized by isoflurane inhalation (1–5% v

Open access

Gisele Montano, Pat Clough, Todd Schmitt, Michelle Davis, Karen Steinman, Justine O’Brien, and Todd Robeck

Introduction The use of serial ultrasonography combined with simultaneous endocrine profiling has resulted in a better understanding of follicular wave dynamics in domestic animals ( Ginther et al. 1989 , Bergfelt et al. 1991 , Ginther

Open access

Hannan Al-Lamee, Amy Ellison, Josephine Drury, Christopher J Hill, Andrew J Drakeley, Dharani K Hapangama, and Nicola Tempest

/M and anticardiolipin antibodies), thrombophilia (activated protein C resistance, Leiden factor V mutation, prothrombin gene mutation, protein C and S deficiency and antithrombin III deficiency), uterine anomaly (as seen on transvaginal ultrasonography

Open access

Tsafrir S Kolatt, Yoel Shufaro, Shlomo Mashiach, Bernard Czernobilsky, Sarit Aviel-Ronen, Liat Apel-Sarid, Mazal Dahan, and Yuval Or

Madec F Costiou P Terqui M 2000 Ultrasonography and Reproduction in Swine . Paris : INRA . Murray MJ Meyer WR Zaino RJ Lessey BA Novotny DB Ireland K Zeng D Fritz MA 2004 A critical analysis of the accuracy, reproducibility, and

Open access

QiaoYao Huang, YanRu Niu, LiJun Song, JinZhi Huang, Chenxi Wang, and TianZhong Ma

pregnancy and delivery before the current pregnancy, had no stillbirths, no history of spontaneous abortion, no medication use, and no history of viral infection. During the current pregnancy, there were no threatened abortion symptoms or signs, and B-ultrasonography