Assessment of the fetal lungs in utero

Avena-Zampieri, Carla L; Hutter, Jana; Rutherford, Mary; Milan, À; Hall, Megan; Egloff, Alexia; Lloyd, David; Nanda, Surabhi; Greenough, Anne; Story, Lisa

doi:10.1016/j.ajogmf.2022.100693

Cited by 15 publications

(14 citation statements)

References 106 publications

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“…Due to the retrospective study design, routinely performed repeated MRI acquisitions from a single examination were utilised rather than repeated fetal MRI scans. While T2-weighted images are widely used for visual assessment of the fetal lung [ 34 ], it is not known which MRI sequence is best suited for radiomics-based analysis. The radiomics feature set included in the current analysis is limited, but is compatible with the Image Biomarker Standardisation Initiative guidelines [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of 2D versus 3D radiomics for quantitative assessment of fetal lung development: a retrospective fetal MRI study

et al. 2023

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Purpose To investigate the reproducibility of radiomics features extracted from two-dimensional regions of interest (2D ROIs) versus whole lung (3D) ROIs in repeated in-vivo fetal magnetic resonance imaging (MRI) acquisitions. Methods Thirty fetal MRI scans including two axial T2-weighted acquisitions of the lungs were analysed. 2D (lung at the level of the carina) and 3D (whole lung) ROIs were manually segmented using ITK-Snap. Ninety-five radiomics features were extracted from 2 and 3D ROIs in initial and repeat acquisitions using Pyradiomics. Radiomics feature intra-class correlation coefficients (ICC) were calculated between 2 and 3D ROIs in the initial acquisition, and between 2 and 3D ROIs in repeated acquisitions, respectively. Results MRI data of 11 (36.7%) female and 19 (63.3%) male fetuses acquired at a median 25 + 0 gestational weeks plus days (GW) (interquartile range [IQR] 23 + 4 − 27 + 0 GW) were assessed. Median radiomics feature ICC between 2 and 3D ROIs in the initial MRI acquisition was 0.733 (IQR 0.313–0.814, range 0.018–0.970). ICCs between radiomics features extracted using 3D ROIs in initial and repeat acquisitions (median 0.908 [IQR 0.824–0.929, range 0.335–0.996]) were significantly higher compared to 2D ROIs (0.771 [0.699–0.835, 0.048–0.965]) (p < 0.001). Conclusion Fetal MRI radiomics features extracted from 3D whole lung segmentation masks showed significantly higher reproducibility across repeat acquisitions compared to 2D ROIs. Therefore, fetal MRI whole lung radiomics features are robust diagnostic and potentially prognostic tools in the image-based in-vivo quantitative assessment of lung development.

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Section: Discussionmentioning

confidence: 99%

Reproducibility of 2D versus 3D radiomics for quantitative assessment of fetal lung development: a retrospective fetal MRI study

et al. 2023

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“…Although mean T2* values have been assessed in other fetal organs 18 including the liver 19 , spleen 20 and lungs, 12,20 few studies have previously assessed fetal brain development using this technique 21–23 . Previous work has assessed the fetal brain using T2* relaxometry in a group of healthy pregnancies as well as those complicated by placental insufficiency on a 3T MRI scanner between 21 +5 and 38 +4 weeks gestation 23 .…”

Section: Discussionmentioning

confidence: 99%

“…We have previously demonstrated using motion corrected anatomical fetal MRI that cerebral cortical volumes and extracerebral spinal fluid volumes are reduced in fetuses that subsequently deliver preterm, 11 supporting the hypothesis that alterations in brain development may precede sPTB. However, the ability of MRI to provide functional information about fetal tissue 12 is now possible due to novel acquisition and processing techniques 13,14 . T2* imaging harnesses the fact that oxygenated and deoxygenated haemoglobin have different paramagnetic properties, thereby providing an indirect assessment of tissue oxygenation and metabolic activity in the fetal brain.…”

Section: Introductionmentioning

confidence: 99%

Functional assessment of brain development in fetuses that subsequently deliver very preterm: An MRI pilot study

Story,

Uus,

Hall

et al. 2023

Prenatal Diagnosis

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ObjectivesTo evaluate changes occurring in the fetal brain prior to very preterm delivery using MRI T2* relaxometry, an indirect assessment of tissue perfusion.MethodFetuses that subsequently delivered spontaneously <32 weeks gestation and a control cohort were identified from pre‐existing datasets. Participants had undergone a 3T MRI assessment including T2* relaxometry of the fetal brain using a 2D multi‐slice gradient echo single shot echo planar imaging sequence. T2* maps were generated, supratentorial brain tissue was manually segmented and mean T2* values were generated. Groups were compared using quadratic regression.ResultsTwenty five fetuses that subsequently delivered <32 weeks and 67 that delivered at term were included. Mean gestation at MRI was 24.5 weeks (SD 3.3) and 25.4 weeks (SD 3.1) and gestation at delivery 25.5 weeks (SD 3.4) and 39.7 weeks (SD 1.2) in the preterm and term cohorts respectively. Brain mean T2* values were significantly lower in fetuses that subsequently delivered before 32 weeks gestation (p < 0.001).ConclusionAlterations in brain maturation appear to occur prior to preterm delivery. Further work is required to explore these associations, but these findings suggest a potential window for therapeutic neuroprotective agents in fetuses at high risk of preterm delivery in the future.

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“…As such, the position and size of the heart might also provide insight when assessing these cases. Although multiple 2D measurements can be made, the best assessment method is calculating the lung volume [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…3D sonography is not used for routine lung volumetry because it is too time-consuming and might not be an accurate predictive tool. Using multiplanar mode allows the simultaneous display of three perpendicular views of the lung, thus obtaining its volume [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Thoracic Biometry in Patients with Congenital Diaphragmatic Hernia, a Magnetic Resonance Imaging Study

Neștianu,

Popescu,

Alexandru

et al. 2024

Diagnostics

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This is a retrospective study investigating biometric measurements using magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is one of the more common causes of pulmonary hypoplasia, with grave consequences for the fetus. Inclusion criteria were patients diagnosed with CDH as the only observed anomaly, who underwent MRI examination after the second-trimester morphology ultrasound. The patients came from three university hospitals in Bucharest, Romania. In total, 19 patients were included in the study after applying exclusion criteria. Comparing the observed values of the thoracic transverse diameter, the thoracic anterior–posterior diameter, the thoracic circumference, the thoracic area, and the thoracic volume with values from the literature, we observed a predictive alteration of these parameters, with most showing Gaussian distribution. We observed statistical significance for most of our correlations, except between the observed and expected thoracic anterior–posterior diameters and the observed and expected thoracic volume values. This is very helpful when complex studies that can calculate the pulmonary volume cannot be obtained, as in the case of movement artifacts, and allows the clinicians to better assess the severity of the disease. MRI follow-up in CDH cases is a necessity, as it offers the most accurate thoracic biometry.

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Assessment of the fetal lungs in utero

Cited by 15 publications

References 106 publications

Reproducibility of 2D versus 3D radiomics for quantitative assessment of fetal lung development: a retrospective fetal MRI study

Reproducibility of 2D versus 3D radiomics for quantitative assessment of fetal lung development: a retrospective fetal MRI study

Functional assessment of brain development in fetuses that subsequently deliver very preterm: An MRI pilot study

Thoracic Biometry in Patients with Congenital Diaphragmatic Hernia, a Magnetic Resonance Imaging Study

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