Deep learning based gestational age estimation from multi-view fetal brain magnetic resonance imaging

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: MAE 4.47 days (internal), 6.57 days (external) vs 9.42 days (biometric regression)

• Primary Outcome: Mean absolute error for gestational age estimation

• Nnt Or Sensitivity: R² = 0.96 (internal test set); sensitivity/specificity not reported

• Confidence Interval: Not reported

Clinical Application

Limited by requirement for high-quality fetal MRI and specialised deep learning infrastructure Potential application in tertiary obstetric centres with fetal MRI capability; would require TGA approval for clinical implementation and integration with existing prenatal care pathways Pregnant women requiring fetal brain MRI, particularly when conventional dating methods are unreliable

Abstract

BACKGROUND: Gestational age (GA) is essential for assessing fetal development, but conventional methods such as last menstrual period and ultrasound are often inaccurate, particularly in late pregnancy. Recent advances in deep learning (DL) and MRI offer more reliable and consistent GA estimation by capturing detailed fetal brain development. OBJECTIVE: This study aimed to develop deep learning models for GA prediction using multi-view fetal brain MRI and to compare their performance with conventional biometric regression techniques. MATERIALS AND METHODS: A total of 1,321 fetal MRI scans were used to train and evaluate various DL models, while an additional 80 publicly available MRI scans served as an external test set. Two training strategies were explored: transfer learning versus training from scratch, and single-view versus multi-modality input. RESULTS: The pre-trained ResNet-101 model achieved a mean absolute error (MAE) of 4.47 days and a coefficient of determination (R2) of 0.96 on the internal test set. On the external test set, the model yielded an MAE of 6.57 days, outperforming the biometric regression method, which achieved an MAE of 9.42 days. Explainability analysis revealed that the model predominantly focused on the lateral ventricles, cerebellum, and surrounding brain regions for GA prediction. CONCLUSIONS: The integration of multi-view MRI and transfer learning significantly enhanced the predictive accuracy of DL models for GA estimation. The proposed approach outperformed conventional biometric regression and highlighted clinically relevant anatomical regions, demonstrating its potential for use in prenatal diagnostic applications.

References

1. 1.Luo, S., Liu, M., Lv, N. Z., Dai, G. W., Ma, K. J., Zhan, M. J., Sun, Y. X., Yang, H. K., Deng, Z. H., Wang, Y. H., Chen, H., & Fan, F. (2026). Deep learning based gestational age estimation from multi-view fetal brain magnetic resonance imaging. Pediatric Radiology. https://doi.org/10.1002/mp.16875