Applicability of three-dimensional imaging techniques in fetal medicine

Abstract

ObjectiveTo generate physical models of fetuses from images obtained with three-dimensional ultrasound (3D-US), magnetic resonance imaging (MRI), and, occasionally, computed tomography (CT), in order to guide additive manufacturing technology.Materials and MethodsWe used 3D-US images of 31 pregnant women, including 5 who were carrying twins. If abnormalities were detected by 3D-US, both MRI and in some cases CT scans were then immediately performed. The images were then exported to a workstation in DICOM format. A single observer performed slice-by-slice manual segmentation using a digital high resolution screen. Virtual 3D models were obtained from software that converts medical images into numerical models. Those models were then generated in physical form through the use of additive manufacturing techniques.ResultsPhysical models based upon 3D-US, MRI, and CT images were successfully generated. The postnatal appearance of either the aborted fetus or the neonate closely resembled the physical models, particularly in cases of malformations.ConclusionThe combined use of 3D-US, MRI, and CT could help improve our understanding of fetal anatomy. These three screening modalities can be used for educational purposes and as tools to enable parents to visualize their unborn baby. The images can be segmented and then applied, separately or jointly, in order to construct virtual and physical 3D models.

Three‐dimensional real and virtual models in fetal surgery: a real vision

“…CT uses ionizing radiation to visualize tissue structures 1 . Typically, the recommended maximum dose of radiation in order to avoid a fetal teratogenic effect is 0.15 Gy.…”

“…Advances in technology have enabled several breakthroughs within the field of medicine in general, and fetal surgery is no exception 1,2 . Integration of imaging modalities, such as ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI), and reconstructive techniques, to provide comprehensive imagery of fetal anatomy 1 , can contribute to the development of plans for correcting various congenital defects in utero, improving fetal and maternal outcomes.…”

Evaluation of the fetal abdomen by magnetic resonance imaging. Part 1: malformations of the abdominal cavity

“…The importance of imaging methods in the diagnosis of congenital malformations ( 1 - 3 ) , especially in fetal medicine ( 4 - 7 ) , has been the objective of a series of recent studies conducted in Brazil. Because of improvements in image resolution, together with the development of tissue-specific contrast agents, increases in the speed of image acquisition, and the availability of software for image processing, as well as its wide field of view, magnetic resonance imaging (MRI) has become an important tool in fetal diagnostics.…”

Evaluation of the fetal abdomen by magnetic resonance imaging. Part 2: abdominal wall defects and tumors

“…The importance of imaging methods in the diagnosis of congenital malformations ( 1 - 3 ) , and especially in fetal medicine ( 4 - 7 ) , has been the objective of a series of recent studies conducted in Brazil. Ultrasound continues to be the preferred method for evaluating fetal malformations because of its wide acceptance, low cost, and low risk for the mother and fetus.…”