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

OBJECTIVE: 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. STUDY DESIGN: 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. RESULTS: 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. CONCLUSION: Fetal lung ultrasound textures extracted by AQUA provided robust features to predict TDx-FLM results.