Texture analysis of placental MRI: can it aid in the prenatal diagnosis of placenta accreta spectrum?

Chen, Eric; Mar, Woongchon; Horowitz, Jeanne M.; Allen, Amanda; Jha, Priyanka; Cantrell, Donald R.; Cai, Kejia

doi:10.1007/s00261-019-02104-1

Cited by 33 publications

(29 citation statements)

References 26 publications

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“…Radiomics analysis provides us a quantitative method to reflect tissue or tumor heterogeneity and tends to be more stable compared with subjective evaluation. The studies of radiomics analysis for placenta evaluation have emerged recently but until now are relatively rare [17], [18], [19], [20]. These studies found texture analysis of placenta is a feasible tool for PAS diagnosis and even PAS severity assessment [18].…”

Section: Introductionmentioning

confidence: 99%

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Yao

Liu

et al. 2019

EBioMedicine

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BackgroundIdentification of pregnancies with postpartum haemorrhage (PPH) antenatally rather than intrapartum would aid delivery planning, facilitate transfusion requirements and decrease maternal complications. MRI has been increasingly used for placenta evaluation. Here, we aim to build a nomogram incorporating both clinical and radiomic features of placenta to predict the risk for PPH in pregnancies during caesarian delivery (CD).MethodsA total of 298 pregnant women were retrospectively enrolled from Henan Provincial People's Hospital (training cohort: n = 207) and from The Third Affiliated Hospital of Zhengzhou University (external validation cohort: n = 91). These women were suspected with placenta accreta spectrum (PAS) disorders and underwent MRI for placenta evaluation. All of them underwent CD and were singleton. PPH was defined as more than 1000 mL estimated blood loss (EBL) during CD. Radiomic features were selected based on their correlations with EBL. Radiomic, clinical, radiological, clinicoradiological and clinicoradiomic models were built to predict the risk of PPH for each patient. The model with the best prediction performance was validated with its discrimination ability, calibration curve and clinical application.FindingsThirty-five radiomic features showed strong correlation with EBL. The clinicoradiomic model resulted in the best discrimination ability for risk prediction of PPH, with AUC of 0.888 (95% CI, 0.844–0.933) and 0.832 (95% CI, 0.746–0.913), sensitivity of 91.2% (95% CI, 85.8%-96.7%) and 97.6% (95% CI, 92.7%-100%) in the training and validation cohort respectively. For patients with severe PPH (EBL more than 2000 mL), 53 out of 55 pregnancies (96.4%) in the training cohort and 18 out of 18 (100%) pregnancies in the validation cohort were identified by the clinicoradiomic model. The model performed better in patients without placenta previa (PP) than in patients with PP, with AUC of 0.983 compared with 0.867, sensitivity of 100% compared with 90.8% in the training cohort, AUC of 0.832 compared with 0.815, sensitivity of 97.6% compared with 97.2% in the validation cohort.InterpretationThe clinicoradiomic model incorporating both prenatal clinical factors and radiomic signature of placenta on T2WI showed good performance for risk prediction of PPH. The predictive model can identify severe PPH with high sensitivity and can be applied in patients with and without PP.

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Section: Introductionmentioning

confidence: 99%

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Yao

Liu

et al. 2019

EBioMedicine

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“…From our previous experience, IVIM parameters did not show statistical difference between the site where placenta separated from uterine wall normally in the patients with placenta accreta and the regions of placenta without placenta accreta [13]. Chen et al [17] also argued that instead of the entire placenta, future studies can focus on only abnormally high risk areas adjacent to the cesarean scar, then more predictive results may be produced, as more homogeneous regions adjacent to abnormal areas may skew the data. Second, our study population mainly included patients with high risk of PAS disorders after ultrasonography, so the results may be biased as MRI is not a method used for screening.…”

Section: Discussionmentioning

confidence: 99%

“…Texture analysis is a part of radiomics and it can achieve quantitative measurement of heterogeneity and other features from images which are beyond the visibility of the eyes [16]. In a recent study of texture analysis of placenta MRI, Chen et al [17] found PAS was associated with higher values for standard deviation of pixel intensity and fractal analysis at every box size which suggested a potential role of the texture analysis in helping the diagnosis of PAS. With the help of functional MRI, we can acquire both morphological and physiological information of the placenta and potentially improves diagnosis of pregnancy complications.…”

Section: Discussionmentioning

confidence: 99%

Can introvoxel incoherent motion MRI be used to differentiate patients with placenta accreta spectrum disorders?

Lü

et al. 2019

Preprint

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The incidence of PAS disorders increased rapidly in recent years, and introvoxel incoherent motion (IVIM) MRI has been applied in the assessment of placenta. The study aims to investigate whether the parameters from IVIM can be used to differentiate patients with PAS disorders complicating placenta previa and secondly to differentiate different categories of PAS disorders. Methods The study participants were comprised of 99 patients with placenta previa, including 16 patients with placenta accreta, 51 patients with increta, 8 patients with percreta and 24 patients without PAS disorders between 28+0 and 39+6 weeks. IVIM MRI was performed on a 1.5T scanner. Perfusion fraction (f), pseudodiffusion coefficient (D*) and standard diffusion coefficient (D) were calculated. Results Women with PAS disorders had a higher perfusion fraction (p=0.019) than women without the disease. Multiple comparisons showed perfusion fraction in patients without PAS disorders was significantly lower than in patients with placenta accreta and percreta(P=0.018 and 0.033 respectively), but was not lower than in patients with increta(p=1). Conclusion Patients with placenta accreta and percreta differed in placental perfusion fraction from women with increta and without PAS disorders.

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“…Texture analysis is a part of radiomics and it can achieve quantitative measurement of heterogeneity and other features from images which are beyond the visibility of the eyes [17]. In a recent study of texture analysis of placenta MRI, Chen et al [18] found PAS was associated with higher values for standard deviation of pixel intensity and fractal analysis at every box size which suggested a potential role of the texture analysis in helping the diagnosis of PAS. With the help of functional MRI, we can acquire both morphological and physiological information of the placenta and potentially improves diagnosis of pregnancy complications.…”

Section: Discussionmentioning

confidence: 99%

Can introvoxel incoherent motion MRI be used to differentiate patients with placenta accreta spectrum disorders?

Lü

et al. 2019

BMC Pregnancy Childbirth

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BackgroundThe incidence of PAS disorders increased rapidly in recent years, and introvoxel incoherent motion (IVIM) MRI has been applied in the assessment of placenta. The study aims to investigate whether the parameters from IVIM can be used to differentiate patients with PAS disorders complicating placenta previa and secondly to differentiate different categories of PAS disorders.MethodsThe study participants were comprised of 99 patients with placenta previa, including 16 patients with placenta accreta, 51 patients with increta, 8 patients with percreta and 24 patients without PAS disorders between 28 + 0 and 39 + 6 weeks. IVIM MRI was performed on a 1.5 T scanner. Perfusion fraction (f), pseudodiffusion coefficient (D*) and diffusion coefficient (D) were calculated.ResultsWomen with PAS disorders had a higher perfusion fraction (p = 0.019) than women without the disease. Multiple comparisons showed perfusion fraction in patients without PAS disorders was significantly lower than in patients with placenta accreta and percreta(P = 0.018 and 0.033 respectively), but was not lower than in patients with increta(p = 1).ConclusionPatients with placenta accreta and percreta differed in placental perfusion fraction from women with increta and without PAS disorders.

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Texture analysis of placental MRI: can it aid in the prenatal diagnosis of placenta accreta spectrum?

Cited by 33 publications

References 26 publications

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Radiomics analysis of placenta on T2WI facilitates prediction of postpartum haemorrhage: A multicentre study

Can introvoxel incoherent motion MRI be used to differentiate patients with placenta accreta spectrum disorders?

Can introvoxel incoherent motion MRI be used to differentiate patients with placenta accreta spectrum disorders?

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