A preliminary study to quantitatively evaluate the development of maturation degree for fetal lung based on transfer learning deep model from ultrasound images.

The evaluation of fetal lung maturity is critical for clinical practice since the lung immaturity is an important cause of neonatal morbidity and mortality. For the evaluation of the development of fetal lung maturation degree, our study established a deep model from ultrasound images of four-cardiac-chamber view plane. A two-stage transfer learning approach is proposed for the purpose of the study. A specific U-net structure is designed for the applied deep model. In the first stage, the model is to first learn the recognition of fetal lung region in the ultrasound images. It is hypothesized in our study that the development of fetal lung maturation degree is generally proportional to the gestational age. Then, in the second stage, the pretrained deep model is trained to accurately estimate the gestational age from the fetal lung region of ultrasound images. Totally 332 patients were included in our study, while the first 206 patients were used for training and the subsequent 126 patients were used for the independent testing. The testing results of the established deep model have the imprecision as 1.56 ± 2.17 weeks on the gestational age estimation. Its correlation coefficient with the ground truth of gestational age achieves 0.7624 (95% CI 0.6779 to 0.8270, P value < 0.00001). The hypothesis that the development of fetal lung maturation degree can be represented by the texture information from ultrasound images has been preliminarily validated. The fetal lung maturation degree can be considered as being represented by the deep model's output denoted by the estimated gestational age.