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Learning the Hidden Signature of Fetal Arch Anatomy: a Three-Dimensional Shape Analysis in Suspected Coarctation of the Aorta

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
JournalJournal of cardiovascular translational research
E-pub ahead of print27 Oct 2022

Bibliographical note

Funding Information: This work was supported by the Wellcome Trust IEH Award (102431) (iFIND project), by core funding from the Wellcome/EPSRC Centre for Medical Engineering (WT203148/Z/16/Z) and by the Rosetrees Trust (A2725). The research was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London and supported by the NIHR Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health. D.F.A. Lloyd acknowledges support from the Rothschild Foundation (2020/2017). P. Lamata holds a Wellcome Trust Senior Research Fellowship (209450/Z/17/Z). Publisher Copyright: © 2022, The Author(s).

King's Authors


Neonatal coarctation of the aorta (CoA) is a common congenital heart defect. Its antenatal diagnosis remains challenging, and its pathophysiology is poorly understood. We present a novel statistical shape modeling (SSM) pipeline to study the role and predictive value of arch shape in CoA in utero. Cardiac magnetic resonance imaging (CMR) data of 112 fetuses with suspected CoA was acquired and motion-corrected to three-dimensional volumes. Centerlines from fetal arches were extracted and used to build a statistical shape model capturing relevant anatomical variations. A linear discriminant analysis was used to find the optimal axis between CoA and false positive cases. The CoA shape risk score classified cases with an area under the curve of 0.907. We demonstrate the feasibility of applying a SSM pipeline to three-dimensional fetal CMR data while providing novel insights into the anatomical determinants of CoA and the relevance of in utero arch anatomy for antenatal diagnosis of CoA. Graphical abstract: [Figure not available: see fulltext.]

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