Establish a normal fetal lung gestational age grading model and explore the potential value of deep learning algorithms in fetal lung maturity evaluation
Open accessAbstract
BACKGROUND: Prenatal evaluation of fetal lung maturity (FLM) is a challenge, and an effective non-invasive method for prenatal assessment of FLM is needed. The study aimed to establish a normal fetal lung gestational age (GA) grading model based on deep learning (DL) algorithms, validate the effectiveness of the model, and explore the potential value of DL algorithms in assessing FLM. METHODS: A total of 7013 ultrasound images obtained from 1023 normal pregnancies between 20 and 41 + 6 weeks were analyzed in this study. There were no pregnancy-related complications that affected fetal lung development, and all infants were born without neonatal respiratory diseases. The images were divided into three classes based on the gestational week: class I: 20 to 29 + 6 weeks, class II: 30 to 36 + 6 weeks, and class III: 37 to 41 + 6 weeks. There were 3323, 2142, and 1548 images in each class, respectively. First, we performed a pre-processing algorithm to remove irrelevant information from each image. Then, a convolutional neural network was designed to identify different categories of fetal lung ultrasound images. Finally, we used ten-fold cross-validation to validate the performance of our model. This new machine learning algorithm automatically extracted and classified lung ultrasound image information related to GA. This was used to establish a grading model. The performance of the grading model was assessed using accuracy, sensitivity, specificity, and receiver operating characteristic curves. RESULTS: A normal fetal lung GA grading model was established and validated. The sensitivity of each class in the independent test set was 91.7%, 69.8%, and 86.4%, respectively. The specificity of each class in the independent test set was 76.8%, 90.0%, and 83.1%, respectively. The total accuracy was 83.8%. The area under the curve (AUC) of each class was 0.982, 0.907, and 0.960, respectively. The micro-average AUC was 0.957, and the macro-average AUC was 0.949. CONCLUSIONS: The normal fetal lung GA grading model could accurately identify ultrasound images of the fetal lung at different GAs, which can be used to identify cases of abnormal lung development due to gestational diseases and evaluate lung maturity after antenatal corticosteroid therapy. The results indicate that DL algorithms can be used as a non-invasive method to predict FLM.
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Xia et al. and Chen et al. developed a lung maturation grading model that can be implemented for identifying abnormal development and evaluating the effectiveness of antenatal corticosteroid therapy.
“while Xia et al. and Chen et al. developed a lung maturation grading model that can be implemented for identifying abnormal development and evaluating the effectiveness of antenatal corticosteroid therapy [161,163].”
The maturation process of the fetal lung is an important aspect in clinical practice as it implies the leading cause for neonatal morbidity and mortality.
“The maturation process of the fetal lung is an important aspect in clinical practice as it implies the leading cause for neonatal morbidity and mortality [161].”
Xia et al. and Chen et al. were limited by the analysis of only healthy fetuses.
“the studies of Xia et al. and Chen et al. were limited by the analysis of only healthy fetuses [161,163].”
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- Authors
- Xia, T.-H., Tan, M., Li, J.-H., Wang, J.-J., Wu, Q.-Q., & Kong, D.-X.
- Affiliations
- Capital Medical University (CN)
- Zhejiang University (CN)
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
- The School of Mathematical Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China.
- Venue
- Chinese Medical Journal
- Published
- 2021-07-01
- Volume
- 134
- Issue
- 15
- Pages
- 1828-1837
- ISSN
- 0366-6999 (ISSN-L)
- 2542-5641
- PMC
- PMC8367072
- OpenAlex
- W3179154458
- Cited by
- 24
- References
- 39
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 4
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Chinese Medical Journal (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Keywords
- fetal lung maturity, fetal lung ultrasound, deep learning, convolutional neural networks, gestational age estimation, fetal lung development, antenatal corticosteroids
- MeSH terms
- Deep Learning, Algorithms, Female, Gestational Age, Humans, Infant, Infant, Newborn, Lung, Pregnancy, Neural Networks, Computer
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