IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 54, NO.
6, JUNE 2007
Simultaneous Fetal Magnetocardiography and
Ultrasound/Doppler Imaging
Hui Zhao, Mingli Chen, Barry D. Van Veen, Fellow, IEEE, Janette F. Strasburger, and Ronald T. Wakai*
Abstract—The difficulty of utilizing multimodality diagnostic
imaging techniques for fetal surveillance remains one of the
greatest challenges in providing enhanced prenatal care. In
this Letter we demonstrate the feasibility of performing fetal
magnetocardiography (fMCG) and ultrasound/Doppler imaging
simultaneously, using a multichannel SQUID magnetometer and a
portable ultrasound scanner. Despite large magnetic interference
from the scanner, the implementation of simple noise reduction
procedures and appropriate signal processing techniques yielded
fMCG recordings of sufficient quality for assessment of fetal
heart rate and rhythm. A variation of reference channel filtering,
referred to here as synthetic reference channel filtering, was
used to reduce nonstationary low-frequency interference. The
combination of fMCG and/or fMEG with ultrasound/Doppler
offers new possibilities for assessment of fetal well-being and fetal
cardiac function.
Index Terms—Echocardiography, echo/Doppler, fetal magneto-
cardiography, fetal monitoring, multimodality imaging, reference
channel filtering.
I. INTRODUCTION
N the last few years, fetal magnetocardiography (fMCG)
I and fetal magnetoencephalography (fMEG) have attracted
considerable interest due to their ability to noninvasively assess
fetal cardiac and brain electrophysiology, respectively [1]–[4].
A drawback of these techniques, which utilize extremely sensi-
tive SQUID magnetometers, is their high susceptibility to inter-
ference from electronic equipment, which generally precludes
their simultaneous use in conjunction with most other fetal mon-
itoring methods. In particular, it has not been possible to record
echo/Doppler along with fMCG to investigate electromechan-
ical coupling in the fetal heart or to directly monitor fetal be-
havior with 2d ultrasound during fMCG or fMEG recording.
Recently, several manufacturers have developed portable,
battery-operated ultrasound scanners, which generate much
less interference than ac-powered scanners. In this letter, we
Manuscript received July 18, 2006; revised October 15, 2006. This work was
supported in part by the National Institute of Health (NIH) under Grant R01
HL63174, Grant R01 NS37740, and Grant R21 HD049022. Asterisk indicates
corresponding author.
H. Zhao and M. Chen are with the Department of Medical Physics, University
of Wisconsin-Madison, Madison, WI 53706 USA (e-mail: rtwakai@wisc.edu).
B. D. Van Veen is with the Department of Electrical and Computer Engi-
neering, University of Wisconsin-Madison, Madison, WI 53706 USA.
J. F. Strasburger is with the Department of Pediatrics, Division of Cardiology,
Children’s Hospital of Wisconsin, Milwaukee, WI 53226 USA.
*R. T. Wakai are with the Department of Medical Physics, 1300 Univer-
sity Ave., University of Wisconsin-Madison, Madison, WI 53706 USA (e-mail:
rtwakai@wisc.edu).
Digital Object Identifier 10.1109/TBME.2006.889198
0018-9294/$25.00 © 2007 IEEE
1167
demonstrate the feasibility of performing fetal biomagnetic
recording and ultrasound/Doppler imaging simultaneously.
II. METHODS
A. Characterization of the Interference
The ultrasound scanner used in this study was a Sonosite
TITAN (Bothwell, Washington), equipped with the obstetrical
and cardiac packages, electrocardioraphy (ECG) input, and a
60-mm broadband (2–5 MHz) curved array transducer. Al-
though it is a portable scanner, it can perform all the major
imaging modes required for fetal cardiac and brain imaging, in-
cluding 2D, zoom, color power Doppler, pulsed wave Doppler,
continuous wave Doppler, M-mode, and tissue harmonic
imaging. The magnetic measurements were made using a
3-axis fluxgate magnetometer (FVM-400, MEDA, Dulles,
Virginia) and a 37-channel SQUID magnetometer (Magnes, 4D
Neuroimaging).
For the initial characterization of the interference, the scanner
was situated as it would be for a typical examination, approxi-
mately 1.0 m above the floor and about 1.0 m from the center
of the patient table. The SQUID magnetometer was centered
over the patient table at a height of 1.0 m. The transducer was
placed on the patient table, several cm below the SQUID mag-
netometer. The resulting interference was dominated by large
periodic interference of fundamental frequency 22 Hz and am-
plitude on the order of . This interference originated
predominately from the scanner, as it was highly dependent on
the position of the scanner and was weakly affected by the po-
sition of the transducer. The interference was strongest for 2-D
imaging, was smaller for M-mode and Doppler imaging, and
was affected by the backlighting of the display. The display was
always adjusted to maximum backlighting, which minimized
the interference.
When the transducer was moved, the resulting low-frequency
interference was extremely large, on the order of .
Channels closest to the transducer were often saturated. This
interference was clearly due to a permanent magnetic moment,
as it was present even when the scanner was turned off.
Rather than extensively characterizing the interferences as
a function of position and orientation of the transducer and
scanner, we estimated their respective magnetic moments,
as described in the following paragraph. This allows the in-
terference to be estimated for any given source position and
orientation.
To determine the magnetic moment of the transducer, we
first aligned the moment along the -axis of the fluxgate mag-
netometer by orienting the transducer such that the -magnetic
field component was maximal and the - and -components
1168 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 54, NO. 6, JUNE 2007

were negligible. Measurements of the -magnetic field com-

ponent were then taken at several positions along the -axis.
Plotting this data on a log-log graph showed the expected
falloff. The magnetic moment was computed by fitting the data
to the equation for the magnetic field of a magnetic dipole;
it gave a magnetic dipole moment of .
The permanent moment of the scanner was determined in the
same manner and was found to be 0.58 . This strong
moment arose mainly from magnets used to latch the display
cover, which were subsequently removed with the aid of the
manufacturer.
The periodic interference from the scanner had to be mea-
sured with the SQUID magnetometer due to its lower ampli-
tude. The magnetic signal showed a falloff, implying that
the source was effectively quadrupolar. Empirically, the field
strength is described by , where .

B. Procedures for Reducing the Interference

Having identified the sources of the interference, the fol-
lowing procedures were implemented to minimize interference
in the fMCG recordings. The scanner was placed on the floor
as far away as possible from the SQUID magnetometer, but
within the reach of the operator, limited by the 2-m transducer
cable length. This required the operator to sit on a low chair in
order to operate the scanner. If the scanner was placed at a more
convenient, higher elevation; the amplitude of the interference
increased. For example, raising the scanner from the floor to
a height of 1 m increased the interference from about 4 pT to
about 12 pT.
The low-frequency interference was reduced by degaussing
the transducer using a video tape demagnetizer. This decreased
the magnetic moment by about a factor of 20; repeated de-
gaussing was unsuccessful in further reducing the moment.

C. Acquisition of Simultaneous fMCG and Ultrasound/Doppler

Recordings
Simultaneous fMCG and ultrasound/Doppler recordings
were obtained from 4 women with uncomplicated pregnancies
at gestational ages 26–40 weeks. The recordings were made
in a magnetically-shielded room (Lindgren RF Enclosures,
Glendale Heights, Illinois) using the 37-channel SQUID
magnetometer.
Typically, the transducer was located 3–12 cm from the
SQUID magnetometer during imaging. The duration of the
recordings was 5–10 min. During the last few minutes, the
scanner was turned off so that a period of artifact-free recording
was available for comparison.
Fig. 1. (a) Power spectrum of recording in (b), showing low-frequency interfer-
ence and large, sharp spectral peaks at 22 Hz and harmonics. (b) Multichannel
tracing of a simultaneous fMCG/ultrasound recording taken from a subject at 35
weeks after 1–80 Hz bandpass filtering. For clarity, only 1/3 of the 37 channels
are shown. Channel 28 is closest to the transducer. The sensor layout can be
seen in Fig. 3. Notice that the interference is small in channel 34. (c) Recording
in (b) after notch filtering and synthetic reference channel filtering. In addition,
maternal interference was removed using a matched filter in order to better show
the resolution of the fetal signal. P-waves (arrows) are visible in the recording.

D. Postsignal Processing Techniques

A frequency-domain comb notch filter was used to remove
the periodic interference at harmonics of 22 Hz. Reference
channel noise cancellation was also tried because the reference
channels, consisting of 3 orthogonal magnetometer channels
located approximately 15.8 cm above the signal channels, were
dominated by the 22-Hz interference. The weights of the ref-
erence channels were computed with a linear minimum mean
square error algorithm, using data in a 1-sec moving window.
Time-domain high-pass filtering was used to remove the low-
frequency interference from the transducer; however, it was not
possible to remove the interference without attenuating such
low-frequency signals of interest as the T-wave. We, therefore,
investigated a phase sensitive filtering method, referred to here
as synthetic reference channel filtering, in which reference chan-
nels were synthesized in software from the signal channels. This
filter is, thus, able to remove interference arising from sources
near the signal channels, as opposed to conventional reference
ZHAO et al.: SIMULTANEOUS FMCG AND ULTRASOUND/DOPPLER IMAGING
Fig. 2. Removal of interference by signal processing from a channel dominated by periodic interference: (a) 1–80 Hz band-pass filtered signal; (b) reference
channel filter output of signal in (a); (c) comb-notch filter output of signal in (a). Removal of interference by signal processing from a channel containing very
large low-frequency interference: (d) 1–80 Hz band-pass- and notch-filtered signal; (e) signal in (d) after synthetic reference channel filtering using fixed weights;
(f) signal in (d) after synthetic reference channel filtering using recomputed weights.
channel filtering, which is intended to eliminate interference
from distant sources.
The basic idea is to divide the rank-37 signal space into a
low rank signal plus interference subspace and an interference
only subspace, using an appropriate spatial filter. Synthetic ref-
erence channels are formed by projecting the data onto the inter-
ference subspace, which is devoid of signal. The signal channels
are obtained by projection onto the signal plus interference sub-
space and generally still contain interference, although this can
be greatly minimized by recording for a brief period with the
scanner turned off.
An effective method of defining the signal plus interference
and interference subspaces is to apply principle component
analysis (PCA) to a brief time-series, , containing a
representative fetal QRS complex [5]. The signal subspace
was defined as the space spanned by the first several principle
eigenvectors of . To minimize signal distortion, the
number of eigenvectors was chosen such that they accounted
for at least 95% of the signal variance; in the vast majority of
cases 2 eigenvectors was sufficient. The interference subspace
was defined as the orthogonal complement.
The synthetic reference channels were derived by performing
PCA on a 1-sec portion of the data, in which the residual inter-
ference was strong in the signal channels. The reference chan-
nels were chosen as the first few principle components, where
the number of channels was chosen such that the corresponding
eigenvectors accounted for at least 95% of the interference vari-
ance. The weight factors were computed from data in the same
1-sec window and were applied to the entire recording. We also
investigated the effect of allowing the weight factors to vary by
recomputing them using a 1-sec sliding window.
III. RESULTS
The amplitude of both the low-frequency and periodic in-
terference varied markedly across the sensor array. Channels
closest to the transducer showed the largest interference, while
channels farthest away showed much less interference (Fig. 1).
1169
Some channels showed notably low interference even though
they were not farthest away. This reflects the vector nature of
the coupling between the magnetic interference and the detec-
tion coils, which vary from channel to channel in their orienta-
tion as well as their position.
Notch filtering was highly effective in removing the periodic
interference from the scanner Fig. 2(c). No distortion of the
signal was evident. The results were fairly insensitive to the de-
tails of the notch filter function. If the amplitude of the periodic
interference was increased as a result of raising the scanner to a
more convenient height, the notch filter was still able to effec-
tively remove the interference. Reference channel filtering was
also effective in removing the periodic interference; however,
an increase in noise was visually apparent Fig. 2(b).
High-pass filtering with a 1-Hz cutoff frequency removed
much of the low-frequency interference due to movement of
the transducer, but typically the residual interference was still
large Fig. 2(d). Further processing using the synthetic reference
channel filter provided a significant improvement [Fig. 2(e) and
(f)]. The filter output was influenced by several factors. Using
fixed weight factors derived from one segment of the recording
generally resulted in smoother signals, while recomputing the
weight factors using a sliding window improved the suppres-
sion of large interference.
In all subjects, the signal-to-noise ratio of the fetal QRS
complex was high enough in the processed recordings to allow
computation of fetal heart rate tracings Fig. 3(a). Waveforms
obtained by averaging 50 consecutive complexes from record-
ings taken during and after ultrasound imaging [Figs. 3(b) and
(c), respectively] showed good consistency in all subjects.
An example of a simultaneous echo/Doppler-fMCG tracing
is shown in Fig. 4. The traces were precisely time-aligned using
a square wave timing signal connected to the ECG input of
the ultrasound scanner and the fMCG data acquisition system.
Using this procedure the tracings can be easily aligned to within
one pixel, which corresponds to approximately 2–10 msec, de-
pending on the sweep speed.
1170 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 54, NO. 6, JUNE 2007

Fig. 3. (a) Fetal heart rate tracing and (b and c) sensor layout display of averaged fMCG waveforms obtained from a subject at 35 week’s gestation. Two-dimen-
sional ultrasound imaging was performed from 0–305 sec. The signals were saturated by large artifact from 305–325 s after the scanner was turned off and moved
away from the magnetometer. The remainder of the recording was artifact-free. The waveforms in (b) were obtained by averaging 50 consecutive complexes in the
first part of the recording during ultrasound scanning and show good consistency with the averaged waveforms in (c), which were derived from the artifact-free
part of the recording.

Fig. 4. Echo/Doppler recording of right ventricular inflow and outflow showing
simultaneous fMCG in the bottom tracing. The negative Doppler velocities rep-
resent inflow during diastole across the tricuspid valve; the positive velocities
represent systolic outflow into the pulmonary artery. Above the Doppler tracing
is a timing signal recorded through the scanner’s ECG input (grey) and through
the fMCG data acquisition system (white and opposite polarity), which is used
to align the Doppler and the fMCG. The timing signal is square, but is dis-
torted by high-pass filtering. The amplitude of the QRS complex in the fMCG
is approximately 3 pT.
IV. DISCUSSION
To our knowledge, this is the first study to demonstrate
the feasibility of performing fMCG and ultrasound/Doppler
imaging simultaneously. With appropriate signal processing,
demagnetization of the tranducer, and other simple measures,
it was possible to derive fMCG recordings of sufficient quality
for assessment of fetal heart rate and rhythm.
In this study we used an off-the-shelf scanner; however,
modest manufacturing modifications could significantly re-
duce the level of magnetic interference. The main desired
improvement is the elimination of all magnetic components
from the transducer and the scanner. Reduction of high-fre-
quency interference from the scanner would further reduce the
signal processing requirements and might allow fMCG to be
visualized in real-time.
The ability to combine fMCG and/or fMEG with ultra-
sound/Doppler offers new possibilities for fetal investigation.
Simultaneous echo/Doppler and fMCG may allow assess-
ment of cardiac function and electromechanical coupling
in utero with efficacy similar to that of echo/Doppler and ECG
postnatally. fMCG complements ultrasound/Doppler with its
ability to assess beat-to-beat fetal heart rate variability and to
provide waveform information; fMEG can detect fetal brain
ZHAO et al.: SIMULTANEOUS FMCG AND ULTRASOUND/DOPPLER IMAGING
activity directly. Currently, the large low-frequency noise is
problematic for fMEG, but eventually this may be overcome
through the use of nonmagnetic transducers and/or transducer
stabilization.
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