Deep learning based gestational age estimation from multi-view fetal brain MRI

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-modality versus multi-modality input. Results: The pre-trained ResNet101 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. Heatmap 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. This approach outperformed conventional biometric regression and highlighted clinically relevant anatomical regions, demonstrating its potential for use in prenatal diagnostic applications.