Feasibility and reproducibility of fetal lung texture analysis by Automatic Quantitative Ultrasound Analysis and correlation with gestational age

Objective: To evaluate the feasibility and reproducibility of fetal lung texture analysis using a novel automatic quantitative ultrasound analysis and to assess its correlation with gestational age.

Methods: Prospective cross-sectional observational study. To evaluate texture features, 957 left and right lung images in a 2D four-cardiac-chamber view plane were previously delineated from fetuses between 20 and 41 weeks of gestation. Quantification of lung texture was performed by the Automatic Quantitative Ultrasound Analysis (AQUA) software to extract image features. A standard learning approach composed of feature transformation and a regression model was used to evaluate the association between texture features and gestational age.

Results: The association between weeks of gestation and fetal lung texture quantified by the AQUA software presented a Pearson correlation of 0.97. The association was not influenced by delineation parameters such as region of interest (ROI) localization, ROI size, right/left lung selected or sonographic parameters such as ultrasound equipment or transducer used.

Conclusions: Fetal lung texture analysis measured by the AQUA software demonstrated a strong correlation with gestational age. This supports further research to explore the use of this technology to the noninvasive prediction of fetal lung maturity.