Performance of an automatic quantitative ultrasound analysis of the fetal lung to predict fetal lung maturity

Abstract

The objective of the study was to evaluate the performance of automatic quantitative ultrasound analysis (AQUA) texture extractor to predict fetal lung maturity tests in amniotic fluid. Singleton pregnancies (24.0-41.0 weeks) undergoing amniocentesis to assess fetal lung maturity (TDx fetal lung maturity assay [FLM]) were included. A manual-delineated box was placed in the lung area of a 4-chamber view of the fetal thorax. AQUA transformed the information into a set of descriptors. Genetic algorithms extracted the most relevant descriptors and then created and validated a model that could distinguish between mature or immature fetal lungs using TDx-FLM as a reference. Gestational age at enrollment was (mean [SD]) 32.2 (4.5) weeks. According to the TDx-FLM results, 41 samples were mature and 62 were not. The imaging biomarker based on AQUA presented a sensitivity 95.1%, specificity 85.7%, and an accuracy 90.3% to predict a mature or immature lung. Fetal lung ultrasound textures extracted by AQUA provided robust features to predict TDx-FLM results.