Ultrasonic evaluation of fetal lung development using deep learning with graph

Background: The neonatal respiratory morbidity that was primarily caused by the immaturity of the fetal lung is an important clinical issue in close relation to the morbidity and mortality of the fetus. In clinics, the amniocentesis has been used to evaluate the fetal lung maturity, which is time-consuming, costly and invasive. As a non-invasive means, ultrasonography has been explored to quantitatively examine the fetal lung in the past decades. However, existing studies required the contour of the fetal lung which was delineated manually. This may lead to significant inter- and intra-observer variations. Methods: We proposed a deep learning model for automated fetal lung segmentation and measurement, which was constructed combined U-Net with Graph model and pre-trained Vgg-16 network. The graph connection would extract stable feature for final segmentation and pre-trained method could speed up convergence.The model was trained with 3500 datasets augmented from 250 ultrasound images with both the fetal lung and heart delineated manually, and tested on 50 ultrasound images. In addition, the correlation between the size of fetal lung/heart as delineated by the model with gestational age was analyzed. Results: The fetal lung and cardiac area were segmented automatically with the accuracy, average Intersection over Union(IoU), sensitivity and precision being 0.991, 0.818, 0.909 and 0.888, respectively. In addition, the size of fetal lung/heart was well correlated with the gestational age, demonstrating good potentials for assessing the fetal development. Conclusions: This study proposed a new robust method for automatic fetal lung segmentation in ultrasound images using Vgg16-GCN-UNet. Our proposed method could be utilized potentially not only to improve existing research in quantitative analyzing the fetal lung using ultrasound imaging technology, but also to alleviate the labor of the clinicians in routine measurement of the fetal lung/cardiac.