Reproducibility of Lung‐to‐Head Ratio Ultrasound Measurements in Congenital Diaphragmatic Hernia

Novoa, Victoria Arruga Novoa y; Sutton, Laura F.; Neis, Allan E.; Marroquin, Amber M.; Freimund, Tamara A.; Coleman, Tracey M.; Praska, Kathleen A.; Ruka, Krystal L.; Warzala, Vicki L.; Sangi‐Haghpeykar, Haleh; Ruano, Rodrigo

doi:10.1002/jum.14557

Cited by 6 publications

(2 citation statements)

References 35 publications

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“…In light of this, several sonographic and MRI tools have been proposed and are an integral part of prenatal CDH work up in most fetal centers. Although sonographic O/E-LHR [3] and LiTR [5] have been shown to be highly reproducible, stomach position only has a fair-to-moderate interoperator reproducibility [13]. In the present study, we evaluated the reproducibility of manually generated lung and liver volume tracings on fetal MRI.…”

Section: Discussionmentioning

confidence: 99%

“…To compare all reviewers, generalized linear mixed models with random effect were used to assess ICC among reviewers. The reviewer with 20+ years of experience was defined as the expert reviewer for comparisons within the Bland-Altman analysis [3]. We classified the level of reproducibility as excellent, good, moderate, or poor based on the 95% confidence intervals (CIs) of the ICC estimates (>0.9, between 0.75 and 0.9, between 0.5 and 0.75, and <0.5, respectively) [20].…”

Section: Methodsmentioning

confidence: 99%

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Reproducibility of Lung and Liver Volume Measurements on Fetal Magnetic Resonance Imaging in Left-Sided Congenital Diaphragmatic Hernia

et al. 2021

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Introduction: Congenital diaphragmatic hernia (CDH) affects 1 in 3,000 live births and is associated with significant morbidity and mortality. Methods: A review of fetal magnetic resonance imaging (MRI) examinations was performed for fetuses with left CDH and normal lung controls. Image review and manual tracings were performed by 4 pediatric radiologists; right and left lung volumes in the coronal and axial planes as well as liver volume above and below the diaphragm in the coronal plane were measured. Intra- and interreviewer reproducibility was assessed using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Results: Excellent intra- and interreviewer reproducibility of the right and left lung volume measurements was observed in both axial planes (interreviewer ICC: right lung: 0.97, 95% CI: 0.95–0.99; left lung: 0.97, 95% CI: 0.95–0.98) and coronal planes (interreviewer ICC: right lung: 0.97, 95% CI: 0.95–0.98; left lung: 0.96, 95% CI: 0.93–0.98). Moderate-to-good interreviewer reproducibility was observed for liver volume above the diaphragm (ICC 0.7, 95% CI: 0.59–0.81). Liver volume below the diaphragm had a good-to-excellent interreviewer reproducibility (ICC 0.88, 95% CI: 9.82–0.93). Conclusions: The present study demonstrated an excellent intra- and interreviewer reproducibility of MRI lung volume measurements and good-to-moderate inter- and intrareviewer reproducibility of liver volume measurements after standardization of the methods at our fetal center.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Reproducibility of Lung and Liver Volume Measurements on Fetal Magnetic Resonance Imaging in Left-Sided Congenital Diaphragmatic Hernia

et al. 2021

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Standardization and reproducibility of sonographic stomach position grades in fetuses with congenital diaphragmatic hernia

Ibirogba

Novoa

Sutton

et al. 2019

J of Clinical Ultrasound

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Objectives The purpose of this study was to evaluate the reproducibility of stomach position grading in congenital diaphragmatic hernia (CDH) as proposed by Cordier et al and Basta et al after standardization of the methods at our center. Methods We collected sonographic images from 23 fetuses with left‐sided CDH at our center from 2010 to 2018. Nine operators (one maternal fetal medicine expert and eight sonographers) reviewed the selected images and graded the stomach position according to the methods of Cordier et al and Basta et al. We assessed the interoperator agreement with Fleiss's kappa statistics. Results Overall agreement amongst all operators was moderate for both methods proposed by Cordier et al (k = 0.60, SE 0.07, 95% CI 0.47‐0.73, P < .0001) and Basta et al (k = 0.60, SE 0.06, 95% CI 0.47‐0.73, P < .0001). Interoperator agreement was moderate for grade 3 with the method by Cordier et al (k = 0.45, SE 0.09, 95% CI 0.27‐0.64, P < .0001) and fair for grade 4 with the method by Basta et al (k = 0.33, SE 0.08, 95% CI 0.18‐0.49 P < .0001). Conclusions Our study demonstrates a fair to moderate interoperator agreement of the stomach position grading methods proposed in the literature after standardization of the methods at our center. Further multicenter studies are needed to confirm our results.

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Sonographic pulmonary response after tracheal occlusion in fetuses with severe isolated congenital diaphragmatic hernia

Trad

Czeresnia

Ibirogba

et al. 2022

J of Clinical Ultrasound

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Purpose To report the longitudinal lung growth and prognosis of fetuses with severe left sided congenital diaphragmatic hernia (CDH) treated with fetoscopic tracheal occlusion (FETO) in a single institution. Methods Fetal lung size (observed‐to‐expected lung area to head circumference [o/e‐LHR]) was measured in seven consecutive fetuses with isolated severe left‐sided CDH who underwent FETO. Fetal lung growth was used to prognosticate survival and need for ECMO. Results Seven consecutive fetuses had a FETO procedure in the timeframe of this study. A total of 44 longitudinal ultrasound were performed to evaluate lung development. FETO was performed at GA 28.5 ± 0.5 weeks. Five (71.4%) infants survived to one‐year follow‐up and ECMO was needed in three patients (42.8%). Fetal lung response was observed in all fetuses; mean o/e‐LHR increased from 22.5% ± 1.4 before FETO to 44.4% ± 9.8 before delivery. Infants who survived had a higher percentage of fetal lung growth (21.8%) than those who died (8.25%). Conclusion Our study supports the hypothesis that FETO promotes fetal lung growth in fetuses with severe left‐sided CDH, and the fetal pulmonary response seems to be associated with improved outcomes after the procedure.

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Reproducibility of Lung‐to‐Head Ratio Ultrasound Measurements in Congenital Diaphragmatic Hernia

Abstract: We demonstrated that the lung-to-head ratio tracing method has high interoperator reproducibility and the best agreement among the operators at our center. Further multicenter studies are necessary to confirm our results.

Cited by 6 publications

References 35 publications

Reproducibility of Lung and Liver Volume Measurements on Fetal Magnetic Resonance Imaging in Left-Sided Congenital Diaphragmatic Hernia

Reproducibility of Lung and Liver Volume Measurements on Fetal Magnetic Resonance Imaging in Left-Sided Congenital Diaphragmatic Hernia

Standardization and reproducibility of sonographic stomach position grades in fetuses with congenital diaphragmatic hernia

Sonographic pulmonary response after tracheal occlusion in fetuses with severe isolated congenital diaphragmatic hernia

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