Dedicated ultrasound speckle tracking for quantitative analysis of uterine motion outside pregnancy

Fertility problems are nowadays being paralleled by important advances in assisted reproductive technologies. Yet the success rate of these technologies remains low. There is evidence that fertilization outcome is affected by uterine motion, but solutions for quantitative analysis of uterine motion are lacking. This work proposes a dedicated method for uterine-motion quantification by B-mode transvaginal ultrasound. Motion analysis is implemented by speckle tracking based on block matching after speckle-size regularization. Sum of absolute differences is the adopted matching metrics. Prior to the analysis, dedicated singular value decomposition (SVD) filtering is implemented to enhance the uterine motion over noise, clutter, and uncorrelated motion induced by neighboring organs and probe movements. SVD and block matching are first optimized by a dedicated ex vivo setup. Robustness to noise and speckle decorrelation is improved by median filtering of the tracking coordinates from surrounding blocks. Speckle tracking is further accelerated by a diamond search. The method feasibility was tested in vivo with a longitudinal study on nine women, aimed at discriminating between four selected phases of the menstrual cycle known to show different uterine behavior. Each woman was scanned in each phase for 4 min; four sites on the uterine fundus were tracked over time to extract strain and distance signals along the longitudinal and transversal directions of the uterus. Several features were extracted from these signals. Among these features, median frequency and contraction frequency showed significant differences between active and quiet phases. These promising results motivate toward an extended validation in the context of fertilization procedures.