FetalMLOps: operationalizing machine learning models for standard fetal ultrasound plane classification

Fetal standard plane detection is essential in prenatal care, enabling accurate assessment of fetal development and early identification of potential anomalies. Despite significant advancements in machine learning (ML) in this domain, its integration into clinical workflows remains limited-primarily due to the lack of standardized, end-to-end operational frameworks. To address this gap, we introduce FetalMLOps, the first comprehensive MLOps framework specifically designed for fetal ultrasound imaging. Our approach adopts a ten-step MLOps methodology that covers the entire ML lifecycle, with each phase meticulously adapted to clinical needs. From defining the clinical objective to curating and annotating fetal US datasets, every step ensures alignment with real-world medical practice. ETL (extract, transform, load) processes are developed to standardize, anonymize, and harmonize inputs, enhancing data quality. Model development prioritizes architectures that balance accuracy and efficiency, using clinically relevant evaluation metrics to guide selection. The best-performing model is deployed via a RESTful API, following MLOps best practices for continuous integration, delivery, and performance monitoring. Crucially, the framework embeds principles of explainability and environmental sustainability, promoting ethical, transparent, and responsible AI. By operationalizing ML models within a clinically meaningful pipeline, FetalMLOps bridges the gap between algorithmic innovation and real-world application, setting a precedent for trustworthy and scalable AI adoption in prenatal care.Graphical abstractOverview of the FetalMLOps framework for standard fetal ultrasound plane classification. The pipeline spans the entire machine learning lifecycle, from clinical objective definition, data acquisition and curation, and model development to deployment, monitoring, explainability, and sustainability, bridging the gap between research and clinical practice.