Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review

Davidson, Joseph; Uus, Alena; Matthew, Jacqueline; Egloff, Alexia; Deprez, Maria; Yardley, Iain; Coppi, Paolo De; David, Anna L.; Carmichael, J.; Rutherford, Mary

doi:10.1016/s2352-4642(20)30313-8

Cited by 33 publications

(22 citation statements)

References 74 publications

(122 reference statements)

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“…With US being a quick, non-resource intensive imaging technique, questions of accessibility to fetal MRI and difficulties in post-imaging processing have been raised; however a recent study demonstrating the advances in MRI post-acquisition techniques ensures processing can be completed with relative ease in a less time-consuming manner [32].…”

Section: Comparison Of 2d-ultrasound and 3d-mr Thymus Measurementsmentioning

confidence: 99%

Assessment of the fetal thymus gland: Comparing MRI-acquired thymus volumes with 2D ultrasound measurements

Myers

Hutter

Matthew

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Objectives: The fetal thymus gland has been shown to involute in response to intrauterine infection, and therefore could be used as a non-invasive marker of fetal compartment infection. The objective of this study was to evaluate how accurately 2D ultrasound-derived measurements of the fetal thymus reflect the 3D volume of the gland derived from motion corrected MRI images. Study design: A retrospective study was performed using paired ultrasound and MRI datasets from the iFIND project (http://www.ifindproject.com). To obtain 3D volumetry of the thymus gland, T2weighted single shot turbo spin echo (ssTSE) sequences of the fetal thorax were acquired. Thymus volumes were manually segmented from deformable slice-to-volume reconstructed images. To obtain 2D ultrasound measurements, previously stored fetal cine loops were used and measurements obtained at the 3-vessel-view (3VV) and 3-vessel-trachea view (3VT): anterior-posterior diameter (APD), intrathoracic diameter (ITD), transverse diameter (TD), perimeter and 3-vessel-edge (3VE). Inter-observer and intra-observer reliability (ICC) was calculated for both MRI and ultrasound measurements. Pearson correlation coefficients (PCC) were used to compare 2D-parameters with acceptable ICC to TV. Results: 38 participants were identified. Adequate visualisation was possible on 37 MRI scans and 31 ultrasound scans. Of the 30 datasets where both MRI and ultrasound data were available, MRI had good interobserver reliability (ICC 0.964) and all ultrasound 3VV 2D-parameters and 3VT 3VE had acceptable ICC (>0.75). Four 2D parameters were reflective of the 3D thymus volume: 3VV TD r = 0.540 (P = 0.002); 3VV perimeter r = 0.446 (P = 0.013); 3VV APD r = 0.435 (P = 0.110) and 3VT TD r = 0.544 (P = 0.002). Conclusions: MRI appeared superior to ultrasound for visualization of the thymus gland and reproducibility of measurements. Three 2D US parameters, 3VV TD, perimeter and 3VT APD, correlated well with TV. Therefore, these represent a more accurate reflection of the true size of the gland than other 2D measurements, where MRI is not available.

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Section: Comparison Of 2d-ultrasound and 3d-mr Thymus Measurementsmentioning

confidence: 99%

Assessment of the fetal thymus gland: Comparing MRI-acquired thymus volumes with 2D ultrasound measurements

Myers

Hutter

Matthew

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The antenatal work‐up of fetal thoracic anomalies increasingly includes fetal magnetic resonance imaging (MRI) in recent years. Fetal MRI aids in cases of diagnostic uncertainty by detailed delineation of soft tissues within the fetal chest, differentiating lung, bowel and liver more easily than ultrasound, 1 helping in the assessment of congenital diaphragmatic hernia (CDH) and congenital lung lesions (CLL, including congenital pulmonary airway malformation [CPAM] and bronchopulmonary sequestration [BPS]). The currently standardised prognostic markers for CDH and CPAM are the observed/expected Lung Head Ratio [LHR] (O/E LHR 2 ) and the CPAM volume ratio (CVR 3 ), both measured by ultrasound.…”

Section: Introductionmentioning

confidence: 99%

“…Fetal MRI aids in cases of diagnostic uncertainty by detailed delineation of soft tissues within the fetal chest, differentiating lung, bowel and liver more easily than ultrasound, 1 helping in the assessment of congenital diaphragmatic hernia (CDH) and congenital lung lesions (CLL, including congenital pulmonary airway malformation [CPAM] and bronchopulmonary sequestration [BPS]).…”

Section: Introductionmentioning

confidence: 99%

Motion corrected fetal body magnetic resonance imaging provides reliable 3D lung volumes in normal and abnormal fetuses

et al. 2022

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Objectives To calculate 3D‐segmented total lung volume (TLV) in fetuses with thoracic anomalies using deformable slice‐to‐volume registration (DSVR) with comparison to 2D‐manual segmentation. To establish a normogram of TLV calculated by DSVR in healthy control fetuses. Methods A pilot study at a single regional fetal medicine referral centre included 16 magnetic resonance imaging (MRI) datasets of fetuses (22–32 weeks gestational age). Diagnosis was CDH (n = 6), CPAM (n = 2), and healthy controls (n = 8). Deformable slice‐to‐volume registration was used for reconstruction of 3D isotropic (0.85 mm) volumes of the fetal body followed by semi‐automated lung segmentation. 3D TLV were compared to traditional 2D‐based volumetry. Abnormal cases referenced to a normogram produced from 100 normal fetuses whose TLV was calculated by DSVR only. Results Deformable slice‐to‐volume registration‐derived TLV values have high correlation with the 2D‐based measurements but with a consistently lower volume; bias −1.44 cm3 [95% limits: −2.6 to −0.3] with improved resolution to exclude hilar structures even in cases of motion corruption or very low lung volumes. Conclusions Deformable slice‐to‐volume registration for fetal lung MRI aids analysis of motion corrupted scans and does not suffer from the interpolation error inherent to 2D‐segmentation. It increases information content of acquired data in terms of visualising organs in 3D space and quantification of volumes, which may improve counselling and surgical planning.

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“…Slice-to-volume registration (SVR) tools allow reconstruction of high-resolution isotropic 3D images of the fetal brain (Gholipour et al, 2010; Rousseau et al, 2010; Kuklisova-Murgasova et al, 2012) from multiple low-resolution motion corrupted MRI stacks. The more recently proposed deformable SVR (DSVR) method (Uus et al, 2020) designed for correction of non-rigid motion has also been applied for reconstruction of the fetal trunk (Davidson et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Automated 3D reconstruction of the fetal thorax in the standard atlas space from motion-corrupted MRI stacks for 21-36 weeks GA range

Uus

Grigorescu

Poppel

et al. 2021

Preprint

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Slice-to-volume registration (SVR) methods allow reconstruction of high-resolution 3D images from multiple motion-corrupted stacks. SVR-based pipelines have been increas- ingly used for motion correction for fetal MRI since they allow more informed and de- tailed diagnosis of brain and body anomalies including congenital heart defects (Lloyd et al., 2019). Recently, fully automated rigid SVR reconstruction of the fetal brain in the atlas space was achieved in (Salehi et al., 2019) that used segmentation and pose es- timation convolutional neural networks (CNNs). However, these CNN-based methods have not yet been applied to the fetal body region. Meanwhile, the existing rigid and deformable SVR (DSVR) solutions (Uus et al., 2020) for the fetal trunk region are limited by the requirement of manual input as well the narrow capture range of the classical gradient descent based registration methods that cannot resolve severe fetal motion fre- quently occurring at the early gestational age (GA). Furthermore, in our experience, the conventional 2D slice-wise CNN-based brain masking solutions are reportedly prone to errors that require manual corrections when applied on a wide range of acquisition protocols or abnormal cases in clinical setting. In this work, we propose a fully automated pipeline for reconstruction of the fetal thorax region for 21-36 weeks GA range MRI datasets. It includes 3D CNN-based intra-uterine localisation of the fetal trunk and landmark-guided pose estimation steps that allow automated DSVR reconstruction in the standard radiological space irrespec- tive of the fetal body position or the regional stack coverage. The additional step for generation of the common template space and rejection of outliers provides the means for automated exclusion of stacks affected by low image quality or extreme motion. The pipeline was evaluated on a series of experiments including fetal MRI datasets and simulated rotation motion. Furthermore, we performed a qualitative assessment of the image reconstruction quality in terms of the definition of vascular structures on 100 early (median 23.14 weeks) and late (median 31.79 weeks) GA group MRI datasets covering 21 to 36 weeks GA range.

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Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review

Cited by 33 publications

References 74 publications

Assessment of the fetal thymus gland: Comparing MRI-acquired thymus volumes with 2D ultrasound measurements

Assessment of the fetal thymus gland: Comparing MRI-acquired thymus volumes with 2D ultrasound measurements

Motion corrected fetal body magnetic resonance imaging provides reliable 3D lung volumes in normal and abnormal fetuses

Automated 3D reconstruction of the fetal thorax in the standard atlas space from motion-corrupted MRI stacks for 21-36 weeks GA range

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