A Hybrid Model for Fetal Growth Restriction Assessment by Automatic Placental Radiomics on T2‐Weighted MRI and Multifeature Fusion
Open accessAbstract
Background: MRI‐based placental analyses have been used to improve fetal growth restriction (FGR) assessment by complementing ultrasound‐based measurements. However, these are still limited by time‐consuming manual annotation in MRI data and the lack of mother‐based information. Purpose: To develop and validate a hybrid model for accurate FGR assessment by automatic placental radiomics on T2‐weighted imaging (T2WI) and multifeature fusion. Study Type: Retrospective. Population: 274 pregnant women (29.5 4.0 years) from two centers were included and randomly divided into training (N = 119), internal test (N = 40), time‐independent validation (N = 43), and external validation (N = 72) sets. Field Strength/Sequence: 1.5‐T, T2WI half‐Fourier acquisition single‐shot turbo spin‐echo pulse sequence. Assessment: First, the placentas on T2WI were manually annotated, and a deep learning model was developed to automatically segment the placentas. Then, the radiomic features were extracted from the placentas and selected by three‐step feature selection. In addition, fetus‐based measurement features and mother‐based clinical features were obtained from ultrasound examinations and medical records, respectively. Finally, a hybrid model based on random forest was constructed by fusing these features, and further compared with models based on other machine learning methods and different feature combinations. Statistical Tests: The performances of placenta segmentation and FGR assessment were evaluated by Dice similarity coefficient (DSC) and the area under the receiver operating characteristic curve (AUROC), respectively. A P‐value <0.05 was considered statistically significant. Results: The placentas were automatically segmented with an average DSC of 90.0%. The hybrid model achieved an AUROC of 0.923, 0.931, and 0.880 on the internal test, time‐independent validation, and external validation sets, respectively. The mother‐based clinical features resulted in significant performance improvements for FGR assessment. Data Conclusion: The proposed hybrid model may be able to assess FGR with high accuracy. Furthermore, information complementation based on placental, fetal, and maternal features could also lead to better FGR assessment performance. Level of Evidence: 3. Technical Efficacy: Stage 2.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Other recent multimodal frameworks combining placental MRI with ultrasound and clinical data have achieved external validation AUCs around 0.88.
“Other recent multimodal frameworks combining advanced imaging modalities, such as placental MRI, with ultrasound and clinical data have achieved external validation AUCs around 0.88.16”
From Early detection of severe fetal growth restriction using multimodal deep learning based on ultrasound and prenatal biomarkers (2026) · cites this paper as [16]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Breiman, L. (2001) · Machine Learning · doi:10.1023/a:1010933404324 · Cited by 133,538 · see citing works
Scikit-learn: Machine Learning in Python
Pedregosa, F., Varoquaux, G., Gramfort, A., Michel, V., Thirion, B., Grisel, O., Blondel, M., Müller, A., Nothman, J., Louppe, G., et al. (2012) · arXiv · doi:10.48550/arxiv.1201.0490 · Cited by 71,016 · see citing works
Lecture Notes in Computer Science 1205
(1999) · Industrial Robot the international journal of robotics research and application · doi:10.1108/ir.1999.04926fae.001 · Cited by 39,228 · see citing works
SciPy 1.0: fundamental algorithms for scientific computing in Python
Virtanen, P., Gommers, R., Oliphant, T. E., Haberland, M., Reddy, T., Cournapeau, D., Burovski, E., Peterson, P., Weckesser, W., Bright, J., et al. (2020) · Nature Methods · doi:10.1038/s41592-019-0686-2 · Cited by 38,430 · see citing works
A Caution Regarding Rules of Thumb for Variance Inflation Factors
O’brien, R. M. (2007) · Quality & Quantity · doi:10.1007/s11135-006-9018-6 · Cited by 11,217 · see citing works
nnU-Net: a self-configuring method for deep learning-based biomedical image segmentation
Isensee, F., Jaeger, P. F., Kohl, S. A. A., Petersen, J., & Maier-Hein, K. H. (2021) · Nature Methods · doi:10.1038/s41592-020-01008-z · Cited by 10,477 · see citing works
Hearst, M. A., Dumais, S. T., Osuna, E., Platt, J., & Scholkopf, B. (1998) · IEEE Intelligent Systems and their Applications · doi:10.1109/5254.708428 · Cited by 7,243 · see citing works
Computational Radiomics System to Decode the Radiographic Phenotype
(2017) · doi:10.1158/0008-5472.can-17-0339 · Cited by 6,593 · see citing works
Deep learning in medical image analysis
Shen, D., Wu, G., & Suk, H.-I. (2017) · Annual Review of Biomedical Engineering · doi:10.1146/annurev-bioeng-071516-044442 · Cited by 4,968 · see citing works
Zwanenburg, A., Vallières, M., Abdalah, M. A., Aerts, H. J. W. L., Andrearczyk, V., Apte, A., Ashrafinia, S., Bakas, S., Beukinga, R. J., Boellaard, R., et al. (2020) · Radiology · doi:10.1148/radiol.2020191145 · Cited by 4,177 · see citing works
Hastie, T. J., Rosset, S., Zhu, J., & Zou, H. (2009) · Statistics and Its Interface · doi:10.4310/sii.2009.v2.n3.a8 · Cited by 1,907 · see citing works
Consensus definition of fetal growth restriction: a Delphi procedure: Consensus definition of FGR
Gordijn, S. J., Beune, I. M., Thilaganathan, B., Papageorghiou, A., Baschat, A. A., Baker, P. N., Silver, R. M., Wynia, K., & Ganzevoort, W. (2016) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.15884 · Cited by 1,638 · see citing works
Pathophysiology of placental-derived fetal growth restriction
Burton, G. J., & Jauniaux, E. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.11.577 · Cited by 1,070 · see citing works
Medical Image Computing and Computer Assisted Intervention – MICCAI 2018
Frangi, A. F., Schnabel, J. A., Davatzikos, C. A., Alberola-López, C., & Fichtinger, G. (2018) · Lecture notes in computer science · doi:10.1007/978-3-030-00937-3 · Cited by 1,049 · see citing works
Yeung, M., Sala, E., Schönlieb, C., & Rundo, L. (2021) · Computerized Medical Imaging and Graphics · doi:10.1016/j.compmedimag.2021.102026 · Cited by 795 · see citing works
ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth
Salomon, L. J., Alfirevic, Z., Da Silva Costa, F., Deter, R. L., Figueras, F., Ghi, T., Glanc, P., Khalil, A., Lee, W., Napolitano, R., et al. (2019) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.20272 · Cited by 704 · see citing works
Rokach, L., & Maimon, O. (2006) · Springer eBooks · doi:10.1007/0-387-25465-x_9 · Cited by 610 · see citing works
Melamed, N., Baschat, A., Yinon, Y., Athanasiadis, A. P., Mecacci, F., Figueras, F., Berghella, V., Nazareth, A., Tahlak, M., McIntyre, D. H., et al. (2021) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13522 · Cited by 590 · see citing works
(2021) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000004251 · Cited by 453 · see citing works
Dimensionality Reduction with Unsupervised Nearest Neighbors
Krämer, O. (2013) · Intelligent systems reference library · doi:10.1007/978-3-642-38652-7 · Cited by 398 · see citing works
Placental Pathology in Early-Onset and Late-Onset Fetal Growth Restriction
Mifsud, W., & Sebire, N. J. (2014) · Fetal Diagnosis and Therapy · doi:10.1159/000359969 · Cited by 328 · see citing works
Diagnosis and surveillance of late-onset fetal growth restriction
Figueras, F., Caradeux, J., Crispi, F., Eixarch, E., Peguero, A., & Gratacos, E. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.12.003 · Cited by 300 · see citing works
Rosenfeld, C. S. (2021) · Journal of Neuroscience Research · doi:10.1002/jnr.24603 · Cited by 280 · see citing works
Vayssière, C., Sentilhes, L., Ego, A., Bernard, C., Cambourieu, D., Flamant, C., Gascoin-Lachambre, G., Gaudineau, A., Grangé, G., Houfflin‐Debarge, V., et al. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.06.021 · Cited by 255 · see citing works
The placenta in fetal growth restriction: What is going wrong?
Sun, C., Groom, K. M., Oyston, C., Chamley, L. W., Clark, A. R., & James, J. L. (2020) · Placenta · doi:10.1016/j.placenta.2020.05.003 · Cited by 253 · see citing works
Intrauterine growth restriction: Clinical consequences on health and disease at adulthood
Armengaud, J.-B., Yzydorczyk, C., Siddeek, B., Peyter, A., & Siméoni, U. (2020) · Reproductive Toxicology · doi:10.1016/j.reprotox.2020.10.005 · Cited by 157 · see citing works
Ortega, M. A., Fraile‐Μartinez, O., Montero, C. G., Sáez, M. A., Álvarez-Mon, M. Á., Torres‐Carranza, D., Álvarez‐Mon, M., Buján, J., García‐Honduvilla, N., Bravo, C., et al. (2022) · Cells · doi:10.3390/cells11030568 · Cited by 156 · see citing works
Rizzo, G., Mappa, I., Bitsadze, V. O., Słodki, M., Khizroeva, J. K., Makatsariya, A. D., & D’Antonio, F. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20406 · Cited by 121 · see citing works
Toal, M., Keating, S. J., Machin, G. A., Dodd, J. M., Adamson, S. L., Windrim, R. C., & Kingdom, J. C. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.09.031 · Cited by 110 · see citing works
Botting, K. J., Loke, X. Y., Zhang, S., Andersen, J. B., Nyengaard, J. R., & Morrison, J. L. (2018) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00180.2017 · Cited by 59 · see citing works
Dahdouh, S., Andescavage, N. N., Yewale, S., Yarish, A., Lanham, D. C., Bulas, D., du Plessis, A. J., & Limperopoulos, C. (2017) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.25806 · Cited by 56 · see citing works
A prediction model for short-term neonatal outcomes in severe early-onset fetal growth restriction
Sharp, A., Jackson, R., Cornforth, C., Harrold, J. A., Turner, M. A., Kenny, L. C., Baker, P. N., Johnstone, E., Khalil, A. A., von Dadelszen, P., et al. (2019) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2019.08.007 · Cited by 43 · see citing works
3D Graph-Connectivity Constrained Network for Hepatic Vessel Segmentation
Li, R., Huang, Y.-J., Chen, H., Liu, X., Yu, Y., Qian, D., & Wang, L. (2021) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2021.3118104 · Cited by 40 · see citing works
Self-citationFetal Growth Restriction Prediction: How to Move beyond
Leite, D. F. B., & Cecatti, J. G. (2019) · The Scientific World JOURNAL · doi:10.1155/2019/1519048 · Cited by 37 · see citing works
Hendrix, M., Bons, J. A. P., Alers, N. O., Severens‐Rijvers, C., Spaanderman, M. E. A., & Al‐Nasiry, S. (2019) · Placenta · doi:10.1016/j.placenta.2019.09.003 · Cited by 37 · see citing works
Lesmes, C., Gallo, D. M., Saiid, Y., et al. (2015) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.14855 · Cited by 30 · see citing works
Choice of Formula and Accuracy of Fetal Weight Estimation in Small‐for‐Gestational‐Age Fetuses
Melamed, N., Ryan, G., Windrim, R. C., Toi, A., & Kingdom, J. C. (2015) · Journal of Ultrasound in Medicine · doi:10.7863/ultra.15.02058 · Cited by 28 · see citing works
Song, F., Li, R., Lin, J., Lv, M., Qian, Z., Wang, L., & Wu, W. (2023) · Placenta · doi:10.1016/j.placenta.2023.02.007 · Cited by 13 · see citing works
Self-citationWhitham, M. D., Reynolds, D. M., Urban, A. R., Ennen, C. S., & Dudley, D. J. (2022) · Journal of Ultrasound in Medicine · doi:10.1002/jum.16001 · Cited by 9 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Kleinbaum DG, 2002, Logistic regression
Cited by
Sorted by citations
Silva, S. N., Uus, A. U., Waheed, H., Bansal, J. K., Clair, K. S., Norman, W., Verdera, J. A., Cromb, D., Woodgate, T., van Poppel, M. P. M., et al. (2025) · Magnetic Resonance in Medicine · doi:10.1002/mrm.70097 · Cited by 6 · see citing works
“4,14 Although highly relevant, 15,16 placenta and amniotic fluid volumes are not often measured with MRI.”
Recent innovations in placental MRI: Integrating visualization and functional imaging
Türk, E. A., Gagoski, B. A., Golland, P., & Grant, P. E. (2026) · Placenta · doi:10.1016/j.placenta.2026.05.014 · Cited by 1 · see citing works
Wang, J., Wang, J., Peng, Y., Hou, F., Zhang, X., & Jin, H. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2688297
“8,15,16 A model based on first-trimester clinical, Doppler, and biochemical parameters reported an AUC of 0.82, suggesting early detection is feasible.”
InfluentialChen, B., Ngremmadji, M. A., & Morel, O. (2024) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.29418
Prediction of Fetal Growth Restriction Using Placental Image Features in BOLD MRI
Nishida, K., Morita, K., Enomoto, N., et al. (2025) · Journal of Advanced Computational Intelligence and Intelligent Informatics · doi:10.20965/jaciii.2025.p0508
Xu, M., Ruan, L., Xu, X., & Qi, H. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1867368
“Placental MRI radiomics and wearable actigraphy studies illustrate how modality-specific encoders may capture structural or behavioral patterns that are difficult to summarize with single manually defined variables (25–28 However, deep learning also introduces important problems.”
InfluentialRoles and applications of artificial intelligence in fetal and placental MRI: a literature review
Ding, D., Zhu, F., Tang, X., & Ding, Z. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-026-09494-3
“[104, 105].”
Link‐Sourani, D., Avisdris, N., Shao, X., et al. (2026) · NMR in Biomedicine · doi:10.1002/nbm.70346
Develop and evaluate deep learning models for automated MRI placental segmentation and volumetry
Huang, Y., Luciny, J. S., Hu, Y., Yang, D., Chen, P., Hu, Z., Du, Z., Jiang, L., Zhou, Y., Xia, S., et al. (2026) · Chinese Journal of Academic Radiology · doi:10.1007/s42058-026-00229-z
“Accurate placental segmentation is crucial for assisting clinicians in diagnosing placental disorders and determining fetal delivery strategies, and serving as a critical pre-processing step for automated lesion detection algorithms and radiomics-related research [10].”
Recker, F. (2026) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-2920-1072
- Authors
- Li, R., Song, F., Zhou, Q., Wu, W., Cao, Y., Zhang, G., Qian, Z., & Wang, L.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Shanghai Medical College of Fudan University (CN)
- Corresponding author
- Qian, Zhaoxia
- Wang, Lisheng
- Venue
- Journal of Magnetic Resonance Imaging
- Publisher
- Wiley
- Published
- 2024-04-24
- Volume
- 61
- Issue
- 1
- Pages
- 494-504
- ISSN
- 1053-1807 (ISSN-L)
- 1522-2586
- OpenAlex
- W4395111356
- Semantic Scholar
- 7255336b27e3e9ad47abde090c8cf5fb02a675fe
- Cited by
- 10
- References
- 39
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 1
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Magnetic Resonance Imaging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (12090024)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Keywords
- fetal growth restriction, T2-weighted MRI, deep learning segmentation, feature fusion, random forest, fetal ultrasound measurement, hybrid forecasting model
- MeSH terms
- Deep Learning, Radiomics, Adult, Female, Fetal Growth Retardation, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Placenta, Pregnancy, Retrospective Studies, ROC Curve, Reproducibility of Results, Ultrasonography, Prenatal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review