Deep learning for estimation of fetal weight throughout the pregnancy from fetal abdominal ultrasound

BACKGROUND: Fetal weight is currently estimated from fetal biome -try parameters using heuristic mathematical formulas. Fetal biometry requires measurements of the fetal head, abdomen, and femur. However, this examination is prone to inter-and intraobserver variability because of factors, such as the experience of the operator, image quality, maternal characteristics, or fetal movements. Our study tested the hypothesis that a deep learning method can estimate fetal weight based on a video scan of the fetal abdomen and gestational age with similar performance to the full biometry-based estimations provided by clinical experts. OBJECTIVE: This study aimed to develop and test a deep learning method to automatically estimate fetal weight from fetal abdominal ultra-sound video scans. STUDY DESIGN: A dataset of 900 routine fetal ultrasound examina-tions was used. Among those examinations, 800 retrospective ultrasound video scans of the fetal abdomen from 700 pregnant women between 15 6/7 and 41 0/7 weeks of gestation were used to train the deep learn-ing model. After the training phase, the model was evaluated on an exter-nal prospectively acquired test set of 100 scans from 100 pregnant women between 16 2/7 and 38 0/7 weeks of gestation. The deep learning model was trained to directly estimate fetal weight from ultrasound video scans of the fetal abdomen. The deep learning estimations were com-pared with manual measurements on the test set made by 6 human readers with varying levels of expertise. Human readers used standard 3 measurements made on the standard planes of the head, abdomen, and femur and heuristic formula to estimate fetal weight. The Bland-Altman analysis, mean absolute percentage error, and intraclass correlation coef-ficient were used to evaluate the performance and robustness of the deep learning method and were compared with human readers. RESULTS: Bland-Altman analysis did not show systematic deviations between readers and deep learning. The mean and standard deviation of the mean absolute percentage error between 6 human readers and the deep learning approach was 3.75%+/- 2.00%. Excluding junior readers (residents), the mean absolute percentage error between 4 experts and the deep learn-ing approach was 2.59%+/- 1.11%. The intraclass correlation coefficients reflected excellent reliability and varied between 0.9761 and 0.9865. CONCLUSION: This study reports the use of deep learning to estimate fetal weight using only ultrasound video of the fetal abdomen from fetal biometry scans. Our experiments demonstrated similar performance of human measurements and deep learning on prospectively acquired test data. Deep learning is a promising approach to directly estimate fetal weight using ultrasound video scans of the fetal abdomen.