Ensemble Transfer Learning for Fetal Head Analysis: From Segmentation to Gestational Age and Weight Prediction
Open accessAbstract
Ultrasound is one of the most commonly used imaging methodologies in obstetrics to monitor the growth of a fetus during the gestation period. Specifically, ultrasound images are routinely utilized to gather fetal information, including body measurements, anatomy structure, fetal movements, and pregnancy complications. Recent developments in artificial intelligence and computer vision provide new methods for the automated analysis of medical images in many domains, including ultrasound images. We present a full end-to-end framework for segmenting, measuring, and estimating fetal gestational age and weight based on two-dimensional ultrasound images of the fetal head. Our segmentation framework is based on the following components: (i) eight segmentation architectures (UNet, UNet Plus, Attention UNet, UNet 3+, TransUNet, FPN, LinkNet, and Deeplabv3) were fine-tuned using lightweight network EffientNetB0, and (ii) a weighted voting method for building an optimized ensemble transfer learning model (ETLM). On top of that, ETLM was used to segment the fetal head and to perform analytic and accurate measurements of circumference and seven other values of the fetal head, which we incorporated into a multiple regression model for predicting the week of gestational age and the estimated fetal weight (EFW). We finally validated the regression model by comparing our result with expert physician and longitudinal references. We evaluated the performance of our framework on the public domain dataset HC18: we obtained 98.53% mean intersection over union (mIoU) as the segmentation accuracy, overcoming the state-of-the-art methods; as measurement accuracy, we obtained a 1.87 mm mean absolute difference (MAD). Finally we obtained a 0.03% mean square error (MSE) in predicting the week of gestational age and 0.05% MSE in predicting EFW.
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A benefit of GA AI models was the possibility for application in low-resource countries.
“The benefits of the GA AI models were the possibility for application in low-resource countries [144,145,148,149,152]”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [148]
Section 6 (Strength and Limitations; page unavailable) says the lightweight architecture can run on portable devices and low-end machines without client-server communication, and that the framework includes GA prediction. This supports potential use where computing resources are limited, but the paper does not specifically discuss application in low-resource countries. (LLM, conf=0.78)
Experimental — accuracy not yet measuredAI models are able to enhance image acquisition and diagnostic accuracy in point-of-care US devices, which is of particular significance for application in low-resource settings and medically underserved areas.
“AI models are additionally able to enhance image acquisition and diagnostic accuracy in point-of-care US devices, which is of particular significance for application in low-resource settings and medically underserved areas [34,145,148,199].”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [148]
The Strength and Limitations section (page unavailable) says the authors developed lightweight AI architectures suitable for portable ultrasound devices, and the Results and Discussion section reports strong fetal-head segmentation performance. The paper does not show that AI improves image acquisition or diagnostic accuracy on point-of-care devices, or establish benefits in low-resource or medically underserved settings. Its reference to “low resource” concerns computing requirements. (LLM, conf=0.85)
Experimental — accuracy not yet measuredNamburete et al. and Alzubaidi et al. used the anatomy and growth of the fetal head for GA estimation.
“In addition to this, the studies of Namburete et al. and Alzubaidi et al. similarly used the anatomy and growth of the fetal head for GA estimation [147,148].”
A benefit of GA AI models was application in portable devices.
“and in portable devices [148]”
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References 74 · Cited by 35
Research works printed but not linked: 7
- [12]Ciurte A. Bresson X. Cuadra M.B. A semi-supervised patch-based approach for segmentation of fetal ultrasound imaging Proceedings of the Challenge US: Biometric Measurements from Fetal Ultrasound Images, ISBI 2012 Barcelona, Spain 2–5 May 2012 5 7
- [13]Ponomarev G.V. Gelfand M.S. Kazanov M.D. A multilevel thresholding combined with edge detection and shape-based recognition for segmentation of fetal ultrasound images Proceedings of the Challenge US: Biometric Measurements from Fetal Ultrasound Images, ISBI 2012 Barcelona, Spain 2–5 May 2012 17 19
- [14]Stebbing R.V. McManigle J.E. A boundary fragment model for head segmentation in fetal ultrasound Proceedings of the Challenge US: Biometric Measurements from Fetal Ultrasound Images, ISBI Barcelona, Spain 2–5 May 2012 9 11
- [59]Yang Y. Lv H. Discussion of Ensemble Learning under the Era of Deep Learning arXiv 2021 2101.08387
- [62]Oktay O. Schlemper J. Le Folgoc L. Lee M. Heinrich M. Misawa K. Mori K. McDonagh S. Y Hammerla N. Kainz B. Attention U-Net: Learning Where to Look for the Pancreas arXiv 2018 1804.03999
- [68]Goodfellow I. Bengio Y. Courville A. Deep Learning MIT Press Cambridge, MA, USA 2016
- [79]Voglis C. Lagaris I. A rectangular trust region dogleg approach for unconstrained and bound constrained nonlinear optimization Proceedings of the WSEAS International Conference on Applied Mathematics Corfu Island, Greece 17–19 August 2004 Volume 7
- Authors
- Alzubaidi, M., Agus, M., Shah, U., Makhlouf, M., Alyafei, K., & Househ, M.
- Affiliations
- Hamad bin Khalifa University (QA)
- Sidra Medical and Research Center (QA)
- Corresponding author
- Alzubaidi, Mahmood
- Househ, Mowafa
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2022-09-15
- Volume
- 12
- Issue
- 9
- Pages
- 2229
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC9497941
- OpenAlex
- W4296104365
- Cited by
- 35
- References
- 74
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 8 · 2023: 9 · 2022: 1
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Qatar National Library
- Topics
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Advanced Neural Network Applications
- Keywords
- fetal head segmentation, ensemble transfer learning, gestational age estimation, estimated fetal weight, prenatal ultrasound, fetal biometry, weighted voting, U-Net variants, multiple linear regression
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