TY - JOUR
T1 - Assessment of normal pulmonary development using functional magnetic resonance imaging techniques
AU - Avena Zampieri, Carla
AU - Hutter, Jana
AU - Deprez, Maria
AU - Payette, Kelly
AU - Hall, Megan
AU - Uus, Alena
AU - Nanda, Surabhi
AU - Milan, Anna
AU - Seed, Paul Townsend
AU - Rutherford, Mary
AU - Greenough, Anne
AU - Story, Lisa
N1 - Funding Information:
L.S., National Institute for Health Research (NIHR) Advanced Fellow, is funded by Health Education England (HEE)/NIHR for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. J.H. is supported by core funding from the Wellcome/Engineering and Physical Sciences Research Council Centre for Medical Engineering [WT203148/Z/16/Z], by the National Institutes of Health Human Placenta Project grant 1U01HD087202-01 (Placenta Imaging Project [PIP]), by the Wellcome Trust, Sir Henry Wellcome Fellowship to J.H., [201374/Z/16/Z], by the UKRI, FLF to J.H. [MR/T018119/1] and by the NIHR Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London.
Funding Information:
L.S., National Institute for Health Research (NIHR) Advanced Fellow, is funded by Health Education England (HEE)/NIHR for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. J.H. is supported by core funding from the Wellcome/Engineering and Physical Sciences Research Council Centre for Medical Engineering [ WT203148/Z/16/Z ], by the National Institutes of Health Human Placenta Project grant 1U01HD087202-01 (Placenta Imaging Project [PIP]), by the Wellcome Trust, Sir Henry Wellcome Fellowship to J.H. , [ 201374/Z/16/Z ], by the UKRI, FLF to J.H. [ MR/T018119/1 ] and by the NIHR Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/3/16
Y1 - 2023/3/16
N2 - BACKGROUND: The mainstay of assessment of the fetal lungs in clinical practice is via evaluation of pulmonary size, primarily using 2D ultrasound and more recently with anatomical magnetic resonance imaging. The emergence of advanced magnetic resonance techniques such as T2* relaxometry in combination with the latest motion correction post-processing tools now facilitates assessment of the metabolic activity or perfusion of fetal pulmonary tissue in vivo. OBJECTIVE: This study aimed to characterize normal pulmonary development using T2* relaxometry, accounting for fetal motion across gestation. METHODS: Datasets from women with uncomplicated pregnancies that delivered at term, were analyzed. All subjects had undergone T2-weighted imaging and T2* relaxometry on a Phillips 3T magnetic resonance imaging system antenatally. T2* relaxometry of the fetal thorax was performed using a gradient echo single-shot echo planar imaging sequence. Following correction for fetal motion using slice-to-volume reconstruction, T2* maps were generated using in-house pipelines. Lungs were manually segmented and mean T2* values calculated for the right and left lungs individually, and for both lungs combined. Lung volumes were generated from the segmented images, and the right and left lungs, as well as both lungs combined were assessed. RESULTS: Eighty-seven datasets were suitable for analysis. The mean gestation at scan was 29.9±4.3 weeks (range: 20.6–38.3) and mean gestation at delivery was 40±1.2 weeks (range: 37.1–42.4). Mean T2* values of the lungs increased over gestation for right and left lungs individually and for both lungs assessed together (P=.003; P=.04; P=.003, respectively). Right, left, and total lung volumes were also strongly correlated with increasing gestational age (P<.001 in all cases). CONCLUSION: This large study assessed developing lungs using T2* imaging across a wide gestational age range. Mean T2* values increased with gestational age, which may reflect increasing perfusion and metabolic requirements and alterations in tissue composition as gestation advances. In the future, evaluation of findings in fetuses with conditions known to be associated with pulmonary morbidity may lead to enhanced prognostication antenatally, consequently improving counseling and perinatal care planning.
AB - BACKGROUND: The mainstay of assessment of the fetal lungs in clinical practice is via evaluation of pulmonary size, primarily using 2D ultrasound and more recently with anatomical magnetic resonance imaging. The emergence of advanced magnetic resonance techniques such as T2* relaxometry in combination with the latest motion correction post-processing tools now facilitates assessment of the metabolic activity or perfusion of fetal pulmonary tissue in vivo. OBJECTIVE: This study aimed to characterize normal pulmonary development using T2* relaxometry, accounting for fetal motion across gestation. METHODS: Datasets from women with uncomplicated pregnancies that delivered at term, were analyzed. All subjects had undergone T2-weighted imaging and T2* relaxometry on a Phillips 3T magnetic resonance imaging system antenatally. T2* relaxometry of the fetal thorax was performed using a gradient echo single-shot echo planar imaging sequence. Following correction for fetal motion using slice-to-volume reconstruction, T2* maps were generated using in-house pipelines. Lungs were manually segmented and mean T2* values calculated for the right and left lungs individually, and for both lungs combined. Lung volumes were generated from the segmented images, and the right and left lungs, as well as both lungs combined were assessed. RESULTS: Eighty-seven datasets were suitable for analysis. The mean gestation at scan was 29.9±4.3 weeks (range: 20.6–38.3) and mean gestation at delivery was 40±1.2 weeks (range: 37.1–42.4). Mean T2* values of the lungs increased over gestation for right and left lungs individually and for both lungs assessed together (P=.003; P=.04; P=.003, respectively). Right, left, and total lung volumes were also strongly correlated with increasing gestational age (P<.001 in all cases). CONCLUSION: This large study assessed developing lungs using T2* imaging across a wide gestational age range. Mean T2* values increased with gestational age, which may reflect increasing perfusion and metabolic requirements and alterations in tissue composition as gestation advances. In the future, evaluation of findings in fetuses with conditions known to be associated with pulmonary morbidity may lead to enhanced prognostication antenatally, consequently improving counseling and perinatal care planning.
KW - Lung development
KW - fetal MRI
KW - prenatal prediction
KW - T2
UR - http://www.scopus.com/inward/record.url?scp=85152949803&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ajogmf.2023.100935
DO - https://doi.org/10.1016/j.ajogmf.2023.100935
M3 - Article
SN - 2589-9333
VL - 5
JO - American Journal of Obstetrics and Gynecology MFM
JF - American Journal of Obstetrics and Gynecology MFM
IS - 6
M1 - 100935
ER -