Using MRI-derived observed-to-expected total fetal lung volume to predict lethality in fetal skeletal dysplasia

Background Pulmonary hypoplasia is the primary cause of perinatal death in lethal skeletal dysplasias. The antenatal ultrasound correlates for lethality are indirect, measuring the thorax (thoracic circumference, TC) or femur compared to the abdomen (TC/AC, FL/AC). A single study has correlated leth...

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Bibliographic Details
Published in:Pediatric radiology 2024-01, Vol.54 (1), p.43-48
Main Authors: Mehollin-Ray, Amy R., Stover, Samantha, Cassady, Christopher I., Zhang, Bin, Calvo-Garcia, Maria, Kline-Fath, Beth
Format: Article
Language:English
Subjects:
Bone dysplasia
Continuity (mathematics)
Female
Femur
Fetus - diagnostic imaging
Fetuses
Hernias, Diaphragmatic, Congenital
Humans
Hypoplasia
Imaging
Lethality
Lung - diagnostic imaging
Lung Volume Measurements
Lungs
Magnetic Resonance Imaging
Mathematical analysis
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Osteochondrodysplasias
Pediatrics
Pregnancy
Prognosis
Radiology
Retrospective Studies
Risk factors
Skeleton
Statistical analysis
Thorax
Ultrasonic imaging
Ultrasonography, Prenatal
Ultrasound
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Summary:Background Pulmonary hypoplasia is the primary cause of perinatal death in lethal skeletal dysplasias. The antenatal ultrasound correlates for lethality are indirect, measuring the thorax (thoracic circumference, TC) or femur compared to the abdomen (TC/AC, FL/AC). A single study has correlated lethality with the observed-to-expected total lung volume (O/E-TFLV) on fetal MRI in 23 patients. Objective Our aim was to define a cutoff value to predict lethality more specifically using MRI-derived O/E-TFLV. Materials and methods Two large fetal center databases were searched for fetuses with skeletal dysplasia and MRI; O/E-TFLV was calculated. Ultrasound measures were included when available. Each was evaluated as a continuous variable against lethality (stillbirth or death in the first month of life). Logistic regression and receiver operating characteristic (ROC) curve analyses evaluated the prediction ability. AUC, sensitivity, and specificity were calculated. P  
ISSN:1432-1998
0301-0449
1432-1998
DOI:10.1007/s00247-023-05825-0